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PubMed2001

The delivery of orthodontic care in New Zealand. Part II: Analysis of a census of dentists.

Part I of this study reported the level and distribution of the supply of specialist orthodontic services in New Zealand. This paper focuses on the amount and variety of orthodontic services supplied by dentists. A questionnaire sent to all dentists in New Zealand sought information on the amount and type of orthodontic treatment carried out between 1 July 1998 and 30 June 1999. The reply rate was 80.9 percent. The majority of dentists carried out some form of orthodontic treatment, predominantly of a minor nature. A small number provided significant amounts of treatment, both simple and complex. The majority of orthodontic treatment and the majority of comprehensive fixed-appliance treatment were undertaken by orthodontists. One-quarter of all orthodontic patients in New Zealand were treated by dentists, irrespective of the complexity of treatment. Nearly a fifth of all full fixed upper and lower appliances, and nearly a third of all single-arch fixed appliances were placed by dentists during the study period. In general, male dentists, dentists over the age of 40, those who had attended an orthodontic continuing education course in the previous 5 years, and those who referred fewer patients to an orthodontist carried out more procedures, including those of a complex nature; they also had a higher average active orthodontic patient load. Wanting to be more or less busy had little influence on the amount or complexity of treatment performed. Dentists in regions with a low supply of specialist orthodontic services provided more comprehensive fixed appliance treatment and had a higher orthodontic patient load. However, the presence or absence of an orthodontist in an urban area seemed to have little impact on the complexity of treatment or the orthodontic patient load of dentists. Despite fewer orthodontists in secondary and minor urban areas, dentists in these areas did not have a higher orthodontic patient load, but carried out a wider range of procedures and more complex procedures than those in main urban areas.

Adult↗
PubMed2003

Orthodontic bonding to porcelain: a comparison of bonding systems.

STATEMENT OF PROBLEM: Direct bonding of orthodontic brackets to porcelain surfaces has been plagued by failure. PURPOSE: The purpose of this study was to compare the bond strengths of several different bonding systems when bonding orthodontic brackets to porcelain-fused-to-metal surfaces. MATERIAL AND METHODS: Fifty natural glazed feldspathic porcelain-fused-to-noble metal disks 6 mm in diameter and 3 mm in height (1 mm metal and 2 mm porcelain) were fabricated and divided into 5 groups of 10. A different bonding system (GC America Fuji LC, American Ortho Spectrum, 3M Transbond, TP Orthodontics Python, and Kerr Herculite) was assigned to each group, and 50 identical orthodontic brackets were bonded (with the above mentioned systems) to each disk according to each manufacturer's instructions. Each system except TP Orthodontics Python conditioned with phosphoric acid (35% to 37.5%) and all systems were primed with silane before bonding. The specimens were subjected to gradual shear forces up to 123 N in a universal testing machine (Instron Corp, Canton, Mass.) until fracture. The shear bond strength of the bonding systems between the porcelain surface and the bracket was measured in megapascals (MPa). Failures were observed via a Zeiss optical microscope (10x); Tukey's HSD Test and analysis of variance were used to determine significance between the bonding systems at P<.05 level of significance. RESULTS: Failure of all of specimens was adhesive between the porcelain surface and the bonding agents. On the basis of a current literature review, bonding systems were categorized as clinically acceptable if they had a shear bond strength of 6 to 8 MPa. The 3M Transbond Bonding System, American Orthodontics Spectrum Bonding System, and GC America Fuji Ortho LC Bonding System performed within this clinically acceptable range (6 to 8 MPa), whereas Kerr Herculite Bonding System and TP Orthodontics Python Bonding System did not (2 to 4 MPa). The bond strengths of GC America Fuji Ortho LC, 3M Transbond, and American Orthodontics Spectrum were significantly greater (mean = 2.3 times) than TP Orthodontics Python or Kerr Herculite bonding systems. CONCLUSION: Within the limitations of this study, the results reaffirm the regimen of conditioning with phosphoric acid and priming with silane before bonding orthodontic brackets to feldspathic porcelain fused to noble metal. All products indicated for this purpose may not achieve satisfactory bond strengths; however, because they do not all include the critical steps of conditioning with phosphoric acid and priming with silane. The 3M Transbond Bonding System, American Orthodontics Spectrum Bonding System, and GC America Fuji Ortho LC Bonding System performed within the clinically acceptable range (6 to 8 MPa), whereas Kerr Herculite Bonding System and TP Orthodontics Python Bonding System did not (2 to 4 MPa).

Acid Etching, Dental↗
PubMed2006

Orthodontic treatment for deep bite and retroclined upper front teeth in children.

BACKGROUND: Correction of the type of dental problem where the bite is deep and the upper front teeth are retroclined (Class II division 2 malocclusion) may be carried out using different types of orthodontic treatment. However, in severe cases, surgery to the jaws in combination with orthodontics may be required. In growing children, treatment may sometimes be carried out using special upper and lower dental braces (functional appliances) that can be removed from the mouth. In many cases this treatment does not involve taking out any permanent teeth. Often, however, further treatment is needed with fixed braces to get the best result. In other cases, treatment aims to move the upper first permanent molars backwards to provide space for the correction of the front teeth. This may be carried out by applying a force to the teeth and jaws from the back of the head using a head brace (headgear) and transmitting this force to a part of a fixed or removable dental brace. This treatment may or may not involve the removal of permanent teeth. In some cases, neither functional appliances nor headgear are required and treatment may be carried out without extraction of any permanent teeth. Instead of using a headgear, in certain cases, the back teeth are held back in other ways such as with an arch across or in contact with the front of the roof of the mouth which links two bands glued to the back teeth. Often in these cases, two permanent teeth are taken out from the middle of the upper arch (one on each side) to provide room to correct the upper front teeth. It is important for orthodontists to find out whether orthodontic treatment only, carried out without the removal of permanent teeth, in children with a Class II division 2 malocclusion produces a result which is any different from no orthodontic treatment or orthodontic treatment only involving extraction of permanent teeth. OBJECTIVES: To establish whether orthodontic treatment, carried out without the removal of permanent teeth, in children with a Class II division 2 malocclusion, produces a result which is any different from no orthodontic treatment or orthodontic treatment involving removal of permanent teeth. SEARCH STRATEGY: The Cochrane Oral Health Group's Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE and EMBASE were searched. The handsearching of the main international orthodontic journals was updated to April 2006. There were no restrictions with regard to publication status or language of publication. International researchers, likely to be involved in Class II division 2 clinical trials, were contacted to identify any unpublished or ongoing trials. SELECTION CRITERIA: Trials were selected if they met the following criteria: randomised controlled trials (RCTs) and controlled clinical trials (CCTs) of orthodontic treatments to correct deep bite and retroclined upper front teeth in children. DATA COLLECTION AND ANALYSIS: Screening of eligible studies, assessment of the methodological quality of the trials and data extraction were to be conducted in duplicate and independently by two review authors. Results were to be expressed as random-effects models using mean differences for continuous outcomes and risk ratios for dichotomous outcomes with 95% confidence intervals. Heterogeneity was to be investigated including both clinical and methodological factors. MAIN RESULTS: No RCTs or CCTs were identified that assessed the treatment of Class II division 2 malocclusion in children. AUTHORS' CONCLUSIONS: It is not possible to provide any evidence-based guidance to recommend or discourage any type of orthodontic treatment to correct Class II division 2 malocclusion in children.

Child↗
PubMed1997

Orthodontic treatment and temporomandibular disorders.

The relationship between orthodontic treatment and temporomandibular disorders (TMDs) has long been of interest to the practicing orthodontist, but only during the past decade have a significant number of clinical studies been conducted that have investigated this association. This interest in orthodontics and TMD in part was prompted in the late 1980s after litigation that alleged that orthodontic treatment was the proximal cause of TMD in orthodontic patients. This litigious climate resulted in an increased understanding of the need for risk management as well as for methodologically sound clinical studies. The findings of current research investigating the relation of orthodontic treatment and TMD can be summarized as follows: (1) signs and symptoms of TMD may occur in healthy persons; (2) signs and symptoms of TMD increase with age, particularly during adolescence, until menopause, and therefore TMDs that originate during orthodontic treatment may not be related to the treatment; (3) in general, orthodontic treatment performed during adolescence does not increase or decrease the chances of development of TMD later in life; (4) the extraction of teeth as part of an orthodontic treatment plan does not increase the risk of TMD; (5) there is no increased risk of TMD associated with any particular type of orthodontic mechanics; (6) although a stable occlusion is a reasonable orthodontic treatment goal, not achieving a specific gnathologic ideal occlusion does not result in signs and symptoms of TMD; and (7) thus far, there is little evidence that orthodontic treatment prevents TMD, although the role of unilateral posterior crossbite correction in children may warrant further investigation.

Humans↗
PubMed2003

Perceived information needs in respect of orthodontics amongst 11-12-year-old girls: a study through health visitor sessions in schools.

AIM: The aims of this study were: to explore: (i) the knowledge and views regarding orthodontics of a group of 11-12-year-old girls attending a school in Southeast London and (ii) the terms that they used to obtain the information. METHODS AND SUBJECTS: The study used Dental Health Education sessions to investigate the aims of the study. Eight DHE sessions at a secondary school for girls were tape recorded. In order to raise the issue of orthodontics and trigger the formation of questions during health education session, a worksheet containing true/false questions, a crossword puzzle regarding orthodontics and some open ended questions was designed and sent to students. They were required to read and complete the worksheet before each session. They were not required to return the completed worksheets to the investigators but did return them to their teachers. The sessions were tape recorded and supplemented by notes taken at the sessions by the investigator. A total of eight DHE sessions, attended by 14 girls each, were tape-recorded. Each tape recording was immediately transcribed verbatim. The next stage was to organize the data and to single out the orthodontic questions and discussions and categorize them. RESULTS: A total of 117 girls aged 11-12-year-old comprised the study group: 77% were white and 23% black children. After reading the transcripts several times, certain themes on orthodontics emerged. The results showed that children questioned different aspects of orthodontics. Nine themes emerged from their questions and discussions. They wanted to know why orthodontic treatment was carried out and when was the right time to start treatment. They were very keen to find out the differences between different orthodontic appliances. The psychosocial impacts of wearing an orthodontic appliance, i.e., experience of pain as well as the need for extraction of some permanent teeth as part of the treatment were of concern. They asked some questions on the need for repair, adjustment and taking care of appliances. The aetiology of malocclusion was another theme that emerged. The students tended to ask questions and describe problems in their own lay terms. CONCLUSION: The methodology used in this study provided an opportunity to assess the information needs with regards to orthodontics of a group of children attending a school in Southwark, London, UK. It was successful in discovering the views and concerns, and to some extent, their knowledge regarding orthodontics and the terms pupils used in asking questions and making comments.

Attitude to Health↗
PubMed2003

Outcome of orthodontic care in 19-year-olds attending the Public Dental Service in Sweden: residual need and demand for treatment.

The study analyses residual need and demand for orthodontic treatment in 19-year-olds attending the Swedish Public Dental Service (PDS). The general practitioners (GPs) had selected individuals for orthodontic specialist consultation and some were treated by GPs or specialists or not considered to be in need for treatment. Altogether 164 individuals were called for clinical investigation at the age of 19 years and also given a questionnaire asking for residual orthodontic treatment demand and satisfaction with information and orthodontic care. Ninety-one per cent of the individuals who had had an orthodontic consultation and 53 per cent of those who had not seen an orthodontist took part in the investigation. The study revealed that half of the 19-year-olds at the PDS clinic had received orthodontic consultations and one third had received orthodontic appliance treatment. Seven percent of the investigated individuals had a residual subjective demand for treatment. Several individuals with removable appliance treatment had overjet and deep bite and laterally forced cross-bite, but with little remaining subjective demand for treatment. Individuals with fixed appliance treatment showed few malocclusions. Nineteen-year-olds in general were uncertain about their present need for orthodontic treatment. The following conclusions were drawn: the total amount of orthodontic treatment in different areas in Sweden is comparable but the distribution between GP and specialist treatment differs. Interceptive treatment to reduce overjets seemed not successful. Fixed appliances seemed to reduce the majority of the malocclusion traits. The information given in connection with orthodontic consultation or treatment was clearly inadequate.

Adult↗
PubMed2004

Changes in response properties of periodontal mechanoreceptors after experimental orthodontic tooth movement in rats.

Using an in vitro preparation, we investigated chronological changes in response properties of periodontal mechanoreceptors (PMRs) in the rat right mandibular first molar (M1) after experimental orthodontic tooth movement. Orthodontic force was applied to M1 for 14 days by activating 24.5 mN superelastic titanium-nickel alloy closed coil springs anchored to the mandibular incisors. Experiments were performed on days 3, 7, 10, and 14 during application of orthodontic force and on days 7, 14, 21, and 28 after removal of orthodontic force. The rats without application of orthodontic force were used as control group. In each group, direct mechanical stimulation using von Frey hairs and electrical stimulation was applied to the distal root of M1. Results showed that compared with controls (1) the mechanical thresholds were significantly lower during application of orthodontic force; however, no significant difference was found after removal of force application and (2) conduction velocities were significantly lower from day 7 during application of orthodontic force to day 14 after removal of orthodontic force; however, no significant difference was found on days 21 and 28 after removal of orthodontic force. These results suggest that the PMRs, although having some of their response properties altered during orthodontic force application, were able to recover and adapt to the newly acquired intraoral condition after removal of the orthodontic force.

Animals↗
PubMed2006

Orthodontic treatment provided by general dentists who have achieved master's level in the Academy of General Dentistry.

INTRODUCTION: The purposes of this study were to document orthodontic treatment currently provided by general dentists for comparison with past and future studies and to ascertain variables that influence practitioners' orthodontic treatment patterns. METHODS: A 21-item survey was mailed to 750 master's level members of the Academy of General Dentistry. Surveys returned within 8 weeks were included for statistical analysis. RESULTS: The response rate was 62%. Most practitioners spent less than 10% of their practice time providing orthodontic treatment and reported that this would not change in the future. Many provided orthodontic treatment in the permanent dentition, and the most common conditions or malocclusions treated were space maintenance, anterior crossbite, rotation, habits, molar uprighting, and posterior crossbite. The most common orthodontic appliances used were removable Hawley appliances with finger springs, straight wire orthodontic therapy, rapid palatal expanders, and functional appliances. CONCLUSIONS: The number of general dentists providing comprehensive orthodontic treatment has not changed since previous surveys; practitioners also do not expect a change in the next 5 years. Factors that influenced the orthodontic treatment provided included the primary source of orthodontic training, the number of orthodontic continuing education hours earned per year, the practitioner's location, and the proximity to the nearest orthodontist.

Adult↗
PubMed1996

Orthodontic services provided by general dentists.

A survey was mailed to a stratified random sample of general dentists to determine the amount and nature of orthodontic treatment provided by general practitioners to their patients. The response to the survey was 75%, a rate considered excellent for this type of mailing. A large majority of the responding dentists (76.3%) provide orthodontic services to their patients, with 19.3% providing comprehensive orthodontic treatment. The percentage of time spent providing orthodontic services varied greatly among general dentists, with only a very few practitioners spending more than 50%. The number of patients under active treatment also varied widely, with only about 17% of those practitioners providing comprehensive treatment having more than 50 patients. A comparison of the three groups of practitioners showed that there was no relationship between the level of orthodontic involvement (none, limited, comprehensive) and the number of miles from orthodontic specialist or the pattern of referrals to orthodontists. Extrapolation of data from this study to the results of other investigations led to an estimate of the relative percentage of treatment provided by orthodontic specialists, pediatric dentists, and general practitioners. Almost two thirds of orthodontic patients are treated by orthodontic specialists, with pediatric dentists treating less than 4%. Slightly less than one third of all orthodontic patients appear to receive treatment from general practitioners.

Comprehensive Dental Care↗
PubMed2006

Orthodontic treatment needs in the western region of Saudi Arabia: a research report.

BACKGROUND: Evaluation of self perceived and actual need for orthodontic treatment helps in planning orthodontic services and estimating the required resources and man power. In the present study, the perceptive need as evaluated by patients and the actual need to orthodontic treatment, as assessed by orthodontists, were evaluated at two types of dental practices in the city of Jeddah using the Index of Orthodontic Treatment Need (IOTN). METHODS: A consecutive sample of 743 adults seeking orthodontic treatment at two different types of dental practices in Jeddah; King Abdulaziz University, Faculty of Dentistry (KAAU) (Free treatment) and two private dental polyclinics (PDP) (Paid treatment), was examined for orthodontic treatment need using the dental health component (DHC) of the IOTN. The self-perceived need for orthodontic treatment was also determined using the aesthetic component (AC) of the IOTN. The IOTN score and the incidence of each variable were calculated statistically. AC and DHC categories were compared using the Chi-Square and a correlation between them was assessed using Spearman's correlation test. AC and DHC were also compared between the two types of dental practices using the Chi-Square. RESULTS: The results revealed that among the 743 patients studied, 60.6% expressed no or slight need for treatment, 23.3% expressed moderate to borderline need and only16.1% thought they needed orthodontic treatment. Comparing these estimates to professional judgments, only 15.2% conformed to little or no need for treatment, 13.2% were assessed as in borderline need and 71.6% were assessed as in need for treatment (p < 0.001). Spearman's correlation test proved no correlation (r = -.045) between the two components. Comparing the AC and the DHC between the KAAU group and PDP group showed significant differences between the two groups (p < 0.001). CONCLUSION: Patient's perception to orthodontic treatment does not always correlate with professional assessment. The IOTN is a valid screening tool that should be used in orthodontic clinics for better services especially, in health centers that provide free treatment.

Adolescent↗
PubMed2006

Radiographs associated with one episode of orthodontic therapy.

Obtaining lifetime diagnostic radiation histories in head and neck cancer studies is often challenging due to the almost universal lack of centralized registries on X-ray utilization in medicine and dentistry. Both the common nature of orthodontics and the young age at which orthodontics typically occurs make it important to quantify what diagnostic radiographs are typically taken during orthodontic therapy. The aim of this study was to assess the number and type of radiographic films associated with one episode of orthodontic therapy in an educational setting. Charts stored in an orthodontic clinic at one academic setting were randomly sampled, and the type and number of radiographic examinations were tallied for the 325 individuals who were in orthodontic therapy for at least one year. Being under orthodontic therapy for one or more years was associated with a median number of seven extra-oral radiographs and twenty-four intra-oral radiographic films. The extra-oral radiographs included three panoramic radiographs and three cephalometric radiographs. Less than 10 percent of the variability was explained by factors such as age, gender, calendar year, surgical orthodontic therapy, and duration of therapy. Head and neck cancer etiology studies should take into account the ionizing radiation during episodes of orthodontic care. The substantial variability in radiographic practices in orthodontics could be reduced by research into clinical utility and by establishing guidelines.

Adolescent↗
PubMed1997

Orthodontic treatment and temporomandibular disorders: is there a relationship? Part 1: Clinical studies.

The relationship between orthodontic treatment and temporomandibular disorders (TMD) has long been of interest to the practicing orthodontist, but only during the last decade or so have a significant number of methodologically-sound clinical studies been conducted that have investigated this association. The aim of this paper is to critically review particularly those studies that have been published since 1989 and to answer the following questions: 1. Does orthodontic treatment with fixed or removable appliances lead to a greater incidence of TMD? 2. Does the extraction of premolars as part of an orthodontic treatment plan result in a greater incidence of TMD? 3. Does orthodontic treatment prevent or cure TMD? For this purpose, we conducted a MEDLINE search, complemented by a hand search in selected journals. We found 21 publications of studies related to the orthodontic-TMD interface. Based on these studies, the following statements can be made: 1. Orthodontic treatment performed during adolescence does not increase or decrease the chances of developing TMD later in life. There is no evidence of an elevated risk for TMD associated with any particular type of orthodontic mechanics. 2. The extraction of teeth as part of an orthodontic treatment plan does not increase the risk of TMD. 3. Thus far, there is no compelling evidence that orthodontic treatment prevents TMD, although the role of unilateral posterior crossbite correction in children may warrant further investigation. Likewise, there is no convincing evidence that TMD can be cured by orthodontic treatment.

Adolescent↗
PubMed1985

Orthodontic therapy in patients with juvenile periodontitis: clinical and microbiologic effects.

The correction of malocclusions in juvenile periodontitis (JP) patients completing periodontal therapy is a problem of increasing clinical concern to orthodontists, since many teeth with severe alveolar bone loss in these patients can now be successfully treated without extraction. In this report, fixed edgewise orthodontic therapy was carried out after the completion of periodontal therapy on four JP patients. The orthodontic therapy included extensive intrusion of teeth severely affected by JP. Phase-contrast microscopic analysis of subgingival plaque from orthodontically treated teeth was used to monitor longitudinally the effects of fixed orthodontic bands on the subgingival flora and also to monitor the efficacy of topical and systemic antimicrobial therapy aimed at suppression of suspected periodontopathic bacteria. Orthodontic movement was completed on most periodontally compromised teeth without significant evidence of additional deterioration in periodontal status. However, within the first 6 months of orthodontic band placement, all patients had significant increases in the number of spirochetes and motile rods in their subgingival flora. Three of the patients also developed high levels of crevicular polymorphonuclear leukocytes around orthodontically treated teeth, indicating significant subgingival inflammation. Intensive antimicrobial measures, including topical inorganic salt applications and systemic tetracycline, were helpful in limiting clinical inflammation and subgingival colonization by periodontopathogens during orthodontic therapy. The results demonstrate that successful orthodontic repositioning can be carried out in treated JP patients. In addition, bacteriologic monitoring and chemotherapeutic suppression of periodontal pathogens may be valuable in the prevention of further destructive periodontal disease activity in periodontitis patients undergoing orthodontic therapy.

Adolescent↗
PubMed1995

Orthognathic surgery versus orthodontic camouflage in the treatment of mandibular deficiency.

Surgical correction of Class II malocclusions, when associated with mandibular deficiency, often has improved results with combined orthodontic and surgical correction compared with orthodontic treatment alone. Strong consideration of surgical correction of mandibular deficiency should be based on the following questions: 1) Do the patient's goals for treatment place a high priority on improvement in facial esthetics? As a corollary, even patients who are not particularly concerned with facial esthetics, but who may have a worsening in facial appearance as a result of orthodontic camouflage, should be considered for surgical correction. This may include patients with lack of upper lip support, an obtuse nasolabial angle, a large nose, and a long lower face height, all of which may become more apparent as a result of orthodontic camouflage treatment. 2) Are the orthodontic movements required in excess of the envelope of discrepancy so that adequate orthodontic correction may not be achieved? 3) Could orthodontic-surgical treatment result in a significant decrease in treatment time? An example would be when surgical treatment in combination with orthodontics could be accomplished without extraction, whereas orthodontic treatment alone would require extraction and space closure. 4) Is there adequate patient compliance? Would orthodontic treatment alone be as ineffective without adequate patient cooperation? 5) Are the risks of surgery within acceptable levels? Are the benefits of surgical treatment, as previously described, obvious?

Adolescent↗
PubMed1995

The effects of orthodontic treatment on isometric bite forces and mandibular motion in patients before orthognathic surgery.

PURPOSE: Little is known about the effects of orthodontic treatment on oral motor function. The objective of this report is to evaluate changes in mandibular motion and maximum bite force that occur between the initiation of presurgical orthodontics and its completion before surgery. PATIENTS AND METHODS: Fifteen patients (9 women, 6 men) with a variety of dentofacial deformities were examined before and after presurgical orthodontics. Mechanical advantage of the muscles and bite points, mandibular range of motion, maximum isometric bite force, and levels of electromyographic (EMG) activity in the anterior and posterior temporalis and masseter muscles during isometric bites were recorded on all subjects over time. Data obtained before and after completion of presurgical orthodontics were statistically compared. RESULTS: Presurgical orthodontics reduced mandibular mobility somewhat, but the amount was not significant. Statistically significant reductions in bite force were noted after orthodontics for incisor, canine, premolar, and molar bite positions. No significant difference in the EMG/bite force slopes was obtained, nor was there any difference in the moment arms of the bite points or the muscles of mastication from orthodontics. CONCLUSIONS: This study showed significant changes in measures of oral motor function resulting from orthodontic treatment. A larger study is needed to confirm that these results will be similar in all orthodontic patients. There is no indication that these changes are the result of physiologic alterations of the muscles of mastication. The best current explanation is that these changes result from the pain and discomfort of the orthodontic appliances and the induced malocclusion.

Adolescent↗
PubMed1993

Orthodontics in Europe 1992.

The removal of economic barriers in Europe in 1992, began a new era in history and will have profound effects on orthodontics throughout Europe. In order to get an estimate of the orthodontic scene in each European country a questionnaire was sent to a well known orthodontist who was asked to fill in the form. The questionnaire consisted of enquiries into four areas of orthodontics. The first dealt with orthodontic specialization in the country and inquired into the numbers of orthodontists, where they practised, how they trained, and whether there was a specialist register. The second part dealt with the orthodontic societies, how many were there, how many members, and the frequency of the meetings. The third area asked about orthodontic practice, dealing with case load, types of appliances used, and the cost of treatment. The last section dealt with the future of orthodontics in their particular country. This related to the demand for orthodontics, the need for orthodontists and the changing patterns of orthodontic practice over the next decade. Twenty-three of the 26 countries in Europe when the questionnaire was sent out responded although some were unable to answer all the questions because orthodontics was not recognized in their country.

Europe↗
PubMed2000

Signs of temporomandibular disorders in girls receiving orthodontic treatment. A prospective and longitudinal comparison with untreated Class II malocclusions and normal occlusion subjects.

The aim of this investigation was to prospectively and longitudinally study signs of temporomandibular disorders (TMD) and occlusal changes in girls with Class II malocclusion receiving orthodontic treatment and to compare them with subjects with untreated Class II malocclusions and with normal occlusion subjects. Three groups of age-matched adolescent girls were examined for clinical signs of TMD and re-examined 2 years later. Sixty-five Class II subjects received orthodontic fixed straight-wire appliance treatment (Orthodontic group), 58 subjects were orthodontically untreated (Class II group), and 60 subjects had a normal occlusion (Normal group). In the Orthodontic group, the prevalence of muscular signs of TMD was significantly less common post-treatment. The Class II and the Normal groups showed minor changes during the 2-year period. Temporomandibular joint clicking increased in all three groups over the 2 years, but was less common in the Normal group. The Normal group also had a lower overall prevalence of signs of TMD than the Orthodontic and the Class II groups at both registrations. Functional occlusal interferences decreased in the Orthodontic group, but remained the same in the other groups over the 2 years. In conclusion, orthodontic treatment did not increase the risk for or worsen pretreatment signs of TMD. On the contrary, subjects with Class II malocclusions and signs of TMD of muscular origin seemed to benefit functionally from orthodontic treatment in a 2-year perspective. The Normal group had a lower prevalence of signs of TMD than the Orthodontic and the untreated Class II groups.

Adolescent↗
PubMed2004

Orthodontic treatment need and demand in 12-14-year-old north Jordanian school children.

This study was undertaken to assess the need and demand for orthodontic treatment among 12-14-year-old north Jordanian school children. In total, 1002 students randomly selected to represent five geographical areas of Irbid were examined. The examinations were carried out twice, first on the pupils in the school premises and then using study models taken from each student. The dental health (DHC) and aesthetic (AC) components of the Index of Orthodontic Treatment Need (IOTN) were used as an assessment measure of the need for orthodontic treatment. The demand for orthodontic treatment was measured by asking the students 'if it was necessary, would they like to have their teeth straightened by an orthodontist'. The results showed that approximately one-third (34 per cent) of the children examined had a definite need for orthodontic treatment. Within this group, 73.5 per cent were in need of orthodontic treatment according to the DHC, 23.5 per cent had both DHC and AC great need scores, and 3 per cent were in need according to the AC only. Severe contact point displacement of more than 4 mm was the most common occlusal feature in the definite treatment need group, followed by impeded eruption of teeth, hypoplasia of a single tooth and increased overjet of more than 6 mm but less than or equal to 9 mm. The demand for orthodontic treatment among the students was 49 per cent. Approximately half of them (54 per cent) had a definite need for orthodontic treatment. This study provides baseline data on the need and demand for orthodontic treatment among a Jordanian population, which is important for planning public orthodontic and dental services.

Adolescent↗