How long does treatment with fixed orthodontic appliances last? A systematic review

INTRODUCTION There is little agreement on the expected duration of a course of orthodontic treatment; however, a consensus appears to have emerged that fixed appliance treatment is overly lengthy. This has spawned numerous novel approaches directed at reducing the duration of treatment, occasionally with an acceptance that occlusal outcomes may be compromised. The aim of this study was to determine the mean duration and the number of visits required for comprehensive orthodontic treatment involving fixed appliances. METHODS Multiple electronic databases were searched with no language restrictions, authors were contacted as required, and reference lists of potentially relevant studies were screened. Randomized controlled trials and nonrandomized prospective studies concerning fixed appliance treatment with treatment duration as an outcome measure were included. Data extraction and quality assessment were performed independently and in duplicate. RESULTS Twenty-five studies were included after screening: 20 randomized controlled trials and 5 controlled clinical trials. Twenty-two studies were eligible for meta-analysis after quality assessment. The mean treatment duration derived from the 22 included studies involving 1089 participants was 19.9 months (95% confidence interval, 19.58, 20.22 months). Sensitivity analyses were carried out including 3 additional studies, resulting in average duration of treatment of 20.02 months (95% confidence interval, 19.71, 20.32 months) based on data from 1211 participants. The mean number of required visits derived from 5 studies was 17.81 (95% confidence interval, 15.47, 20.15 visits). CONCLUSIONS Based on prospective studies carried out in university settings, comprehensive orthodontic treatment on average requires less than 2 years to complete

Dental Research Waste in Design, Analysis, and Reporting: A Scoping Review.

Research waste is highly prevalent across biomedical investigations. We aimed to assess the evidence on the extent of research waste in dental research. We performed a scoping review of empirical evaluations of dental studies assessing the prevalence and impact of limitations in design, conduct, analysis, and reporting of research. PubMed was searched using specific terms to retrieve studies dealing with design, conduct, analysis, and reporting of studies in dentistry, with no year or language restrictions. Of the 1,807 publications identified from the search and from manual searches, 71 were included in this review. The topic and article selection was based on the expert opinion of the authors. The existing evidence suggests that, although there are improvements over time, substantial deficiencies in all areas (design, conduct, analysis, reporting) were prevalent in dental research publications. Waste in research is a multifaceted problem without a simple solution. However, an appreciation of optimal research design and execution is a prerequisite and should be underpinned by policies that include appropriate training in research methods and properly aligned incentives

Historical changes in the phenology of British Odonata are related to climate

Responses of biota to climate change take a number of forms including distributional shifts, behavioural changes and life history changes. This study examined an extensive set of biological records to investigate changes in the timing of life history transitions (specifically emergence) in British Odonata between 1960 and 2004. The results show that there has been a significant, consistent advance in phenology in the taxon as a whole over the period of warming that is mediated by life history traits. British odonates significantly advanced the leading edge (first quartile date) of the flight period by a mean of 1.51 ±0.060 (SEM, n=17) days per decade or 3.08±1.16 (SEM, n=17) days per degree rise in temperature when phylogeny is controlled for. This study represents the first review of changes in odonate phenology in relation to climate change. The results suggest that the damped temperature oscillations experienced by aquatic organisms compared with terrestrial organisms are sufficient to evoke phenological responses similar to those of purely terrestrial taxa

Interlobular and intralobular mammary stroma: Genotype may not reflect phenotype

<p>Abstract</p> <p>Background</p> <p>The normal growth and function of mammary epithelial cells depend on interactions with the supportive stroma. Alterations in this communication can lead to the progression or expansion of malignant growth. The human mammary gland contains two distinctive types of fibroblasts within the stroma. The epithelial cells are surrounded by loosely connected intralobular fibroblasts, which are subsequently surrounded by the more compacted interlobular fibroblasts. The different proximity of these fibroblasts to the epithelial cells suggests distinctive functions for these two subtypes. In this report, we compared the gene expression profiles between the two stromal subtypes.</p> <p>Methods</p> <p>Fresh normal breast tissue was collected from reduction mammoplasty patients and immediately placed into embedding medium and frozen on dry ice. Tissue sections were subjected to laser capture microscopy to isolate the interlobular from the intralobular fibroblasts. RNA was prepared and subjected to microarray analysis using the Affymetrix Human Genome U133 GeneChip^®. Data was analyzed using the Affy and Limma packages available from Bioconductor. Findings from the microarray analysis were validated by RT-PCR and immunohistochemistry.</p> <p>Results</p> <p>No statistically significant difference was detected between the gene expression profiles of the interlobular and intralobular fibroblasts by microarray analysis and RT-PCR. However, for some of the genes tested, the protein expression patterns between the two subtypes of fibroblasts were significantly different.</p> <p>Conclusion</p> <p>This study is the first to report the gene expression profiles of the two distinct fibroblast populations within the human mammary gland. While there was no significant difference in the gene expression profiles between the groups, there was an obvious difference in the expression pattern of several proteins tested. This report also highlights the importance of studying gene regulation at both the transcriptional and post-translational level.</p

How to...mechanically erupt a palatal canine.

Management of ectopic permanent maxillary canines represents one of the greatest challenges to orthodontists. This paper outlines a variety of techniques and mechanics which may facilitate expedient, predictable and safe eruption of palatal canines. While each method may be useful in isolation, the varying presentations of palatal canines ensure that the ability to apply an array of techniques is essential if successful outcomes are to be consistently achieved

Orthodontic trial outcomes: Plentiful, inconsistent, and in need of uniformity? A scoping review.

INTRODUCTION: The selection of appropriate outcomes that matter to both patients and operators is increasingly appreciated, with core outcome sets in clinical trials gaining in popularity. The first step in core outcome set development is the generation of a list of possible important outcomes based on a scoping literature review. Moreover, outcome heterogeneity is known to detract from the findings of systematic reviews and meta-analyses. The aim of this study was to identify the range of outcome domains and specific outcome measures in contemporary orthodontic research. METHODS: Multiple electronic databases were searched from December 31, 2012, to December 31, 2016, to identify clinical trials of orthodontic interventions, with no language restrictions. Abstracts, eligible full texts, and reference lists were screened, and all reported primary and nonprimary outcomes and methods of measurement were recorded. RESULTS: The search identified 1267 abstracts, of which 189 full-text articles were retrieved, and 164 studies were included in the analysis. A total of 54 outcomes were identified and categorized into 14 outcome domains. The most frequently measured outcomes were patient-reported pain, periodontal health, tooth angulation/inclination changes, and treatment duration, followed by rate of tooth movement and skeletal changes. Outcomes that followed the overall course of treatment were assessed in only 14 studies. CONCLUSIONS: Patient perspectives are increasingly being accounted for in orthodontic trials; however, there is little consistency in outcome selection among them. The identified list of outcomes will be used to inform a ranking exercise with service users and providers to establish an agreed core outcome set for future orthodontic clinical trials.Royal College of Surgeons of England and the British Orthodontic Society, which provided funding through a fellowship for Aliki Tsichlaki (grant number OGDF1A1R)

Collaboration in orthodontic clinical trials: prevalence and association with sample size and funding

Abstract Background To assess patterns of research collaboration in orthodontics and possible relationships with sample size and funding status. Methods Orthodontic randomised and non-randomised controlled clinical trials published between 2013 and 2017 were identified through electronic searching. The nature of collaboration, author institutions, study setting, sample size, and funding status were assessed. Linear and logistic regression analyses were applied. Results Of 1153 studies, 217 met the selection criteria. The majority of studies were authored by university academics (86%), were conducted in a single centre (71.9%) and in at least one university hospital (68.2%). The number of practice-based trials (10.1%), as well as the involvement of specialist practitioners (5.2%) in co-authorship, was limited. Multi-centred studies within a single country were associated with a significantly larger sample size compared to single-centred trials (P = 0.00; 95% confidence interval [CI] 33.59, 106.93). However, authorship collaboration either nationally (odds ratio [OR] 2.37; 95% CI 0.85, 6.57) or internationally across different continents (OR 5.54; 95% CI 0.62, 49.52) did not translate into increased funding. Conclusions Most orthodontic studies were undertaken in university hospital settings within a single country. Collaboration is common in orthodontics but involvement of practice settings remains limited, suggesting a need for stimulation of practice-based research and research partnerships

Self-ligating brackets versus conventional pre-adjusted edgewise brackets for treating malocclusion (Protocol).

-National Institute for Health Research (NIHR), UK. -Cochrane Or -al Health Global Alliance, Other

Factors influencing adherence to vacuum-formed retainer wear: A qualitative study.

OBJECTIVE: To explore factors influencing adherence to vacuum-formed retainer wear over a minimum period of four years. DESIGN: A qualitative study based on a randomised controlled trial assessing the effectiveness of orthodontic retainers. SETTING: Institute of Dentistry, Queen Mary University of London. PARTICIPANTS: Fifteen participants wearing vacuum-formed retainers for at least four years. METHODS: One-to-one semi-structured interviews were undertaken on a criterion-based purposive sample of participants wearing vacuum-formed retainers. The interviews were audio-recorded, transcribed verbatim and analysed using Framework Methodology. RESULTS: High self-reported levels of adherence in the early stages of retention were linked to a desire to maintain orthodontic outcomes and the negative perception of potential post-treatment changes. However, adherence typically reduced over time due to a combination of factors including the negative impact of retainers on quality of life and pragmatic issues related to retainer wear. Network support was found to be important in the short and long term, with instances of self-directed wear and negative beliefs concerning the importance of retainer wear and predisposition to post-treatment changes. Lack of follow-up appointments and immaturity of participants prompted independent decisions to cease retainer wear. CONCLUSIONS: Six key influencers of prolonged adherence with vacuum-formed retainer wear were identified. Future strategies to improve adherence should account for these while also being responsive to time elapsed since debond and patient age.European Orthodontic SocietySaudi Arabian Cultural Bureau