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This study investigated incisor trauma in children with overjets greater than or equal to 7 mm who were enrolled in a clinical trial of 2-phase early orthodontic treatment for Class II malocclusion. In phase 1, children were randomly assigned to treatment in the mixed dentition with either modified bionator or combination headgear or to a group in which treatment was delayed until the permanent dentition. All children received comprehensive treatment during phase 2 if necessary. At the start of the trial, 29.1% of the patients had already had some incisor trauma. This was not significantly related to dental developmental age. During the trial, there was an increase in trauma in all 3 groups, but the magnitude of this increase was not significantly greater in the group for which treatment was delayed until the permanent dentition. This might suggest that orthodontic intervention aimed at reducing trauma should begin very soon after the eruption of the maxillary incisors. However, the injuries tended to be minor, and the expected cost of treatment related to incisor trauma was small compared with the expected additional cost of a 2-phase orthodontic intervention. (Am J Orthod Dentofacial Orthop 2003;123:117-26)

Objectives: The aims of this study were to develop a reliable self‐report measure of consumer satisfaction with orthodontic treatment, and to preliminarily assess its validity. Method: Transcripts of qualitative interviews with patients, their parents, and practicing orthodontists together with items from existing dental satisfaction questionnaires were used to develop a pool of 41 items assessing satisfaction with various aspects of orthodontic care. These items were paired with five‐point Likert scales (1=strongly disagree, 5=strongly agree) and were administered to 299 parents of children who had completed orthodontic treatment at two university‐based clinics. Results: Factor analyses and reliability analyses identified three main subscales with high reliabilities: 13 items assessing satisfaction with treatment process (Cronbach's alpha=.92), seven items assessing satisfaction with psychosocial effects of treatment (Cronbach's alpha=.87), and five items assessing satisfaction with overall treatment outcome (Cronbach's alpha=.79). Relationships among these three subscales and pre‐ and posttreatment variables were examined in a subset of 86 parents/patients. Forward stepwise regression with backward overlook revealed no significant relationships between any satisfaction subscale and demographic variables. Posttreatment overjet was inversely related to parental satisfaction with orthodontic treatment process (R2=.13; P<.001), and parent satisfaction with treatment outcome (R2=.28; P<.0001). improvement in esthetics as measured by improvement in IOTN Aesthetic Component scores was positively related to satisfaction with psychosocial outcomes (R2=.28; P<.0001). Conclusions: The present instrument is reliable and can be used to assess three dimensions of parental satisfaction with their child's orthodontic treatment. Relationships between visible orthodontic outcome variables and parent satisfaction provide preliminary validity support for the instrument.

The indications for extracting second premolars are discussed. A progressively banded technique is described, demonstrating the various modifications required to handle cases ranging from space closure to maximum anchorage problems. The advantages of this technique are outlined, and some difficulties that may be encountered are discussed.

In the first phase of a randomized clinical trial of early versus late Class II treatment, statistically significant differences were observed between the treatment and observation groups. However, there were wide variations in response. The change in jaw relationship (categorized as the annualized reduction in ANB angle) was favorable or highly favorable in 76% of the headgear, 83% of the functional appliance, and 31% of control (observation only) groups. The patient's initial skeletal severity, age/maturity at the outset of treatment, growth pattern, and cooperation with treatment were examined as possible influences on early growth modification treatment. Correlations between the annualized change in the ANB angle and any of the possible influences were close to zero and not statistically significant. We conclude that there is little to be gained from precisely timing early treatment to specific age/maturity markers and that a favorable reduction in Class II skeletal problems can occur for patients in a broad range of skeletal severity and growth patterns. Cooperation, measured as the number of hours of reported wear, or the clinical assessment of compliance, explained little of the variation in treatment response. The wide variation in growth seen in the untreated patients highlights the importance of well-controlled studies if clinicians are to improve their ability to select children with the greatest chances of a favorable treatment response. (Am J Orthod Dentofac Orthop 1997;111:533-42.)

The results of an analysis of treatment and post-treatment changes in 48 unselected Class II Division 1 malocclusions are presented. All the cases were at least 1 year out of retention (mean 34·7 months).Mean values have been given for several features. In particular, the mean overjet reduction during treatment was 7·0 mm, the mean relapse 1·1 mm and the mean net overjet reduction 5·9 mm.The relationship of “final” overjet to overbite, overjet, skeletal pattern and lower lip height at different stages of treatment is described. There is wide variation in “final” overjet in relation to any of the single factors investigated but five significant correlations were found.

The interrelationship between form, function and stomatologic health is unclear. However, tooth positions that prevent bacterial plaque removal may predispose towards periodontal disease. A frequent problem in adults is loss of posterior teeth with subsequent tip and drift of the molars. Occlusal trauma, if superimposed on gingival inflammation, can result in rapid tissue destruction. Therefore, an indication for orthodontic treatment is the restoration of normal axial inclination and tooth position so that bacterial plaque control may be effected. Simple orthodontic appliances may be used to restore the position of tipped molars. The benefits of orthodontic treatment, prior to the restoration of the posterior occlusion, are improvement in occlusal loading, improvement of periodontal health and simplification of prosthetic design and fabrication.

The experience of self-poisoning at Stracathro Hospital during 1961–70 has been reviewed. The annual incidence among adult medical admissions rose from 0.7 per cent to 3.1 per cent. It involved mainly the young, the female, the urban dweller, and a relatively high proportion of single, divorced or separated subjects, and occurred mainly at the weekends. Depression was the common associated psychiatric disorder. Suicide was intended more frequently than is noted in the cities.

Two cases of systemic mycoses are described in Africans who must have acquired the disease in Africa. The fungi isolated exhibited all the features of Blastomyces dermatitidis. Full clinical and pathological details are given.

Two hundred and eight admissions to one adult medical ward of the Mulago Hospital, Kampala, were studied for evidence of vitamin E deficiency. Of this number 30.3% were deficient. Patients with malnutrition, cerebrovascular accidents, and liver disease had a high incidence. The possibility that vitamin E deficiency is either etiologically related to the high incidence of cirrhosis of the liver in Uganda, or that it is the result of the liver disease, is briefly discussed.

A study has been made of the drinking patterns of male and female patients admitted to the acute medical wards of a rural district general hospital. Thirty-four per cent of males and 18.5 per cent of females were regular drinkers, while 54 per cent of males and 70.5 per cent of females never, or rarely drank. The young drank more frequently than the elderly. Alcohol ingestion was the determining factor in 7.9 per cent of the male admissions and 7.5 per cent of the female admissions. Drug overdosage was the single most common associated problem.

SummaryTwo groups of patients surviving an acute myocardial infarct were followed up for 12 months after discharge from hospital. One group received regular sulphinpyrazone (600 mg/day) and the other did not. Two sulphinpyrazone-treated subjects died suddenly compared to 6 in the control group, whereas non-fatal acute cardiac ischaemic episodes were equally frequent in the two groups.

Recent publications highlighting autochthonous Babesia canisinfection in dogs from Essex that have not travelled outside the UK are a powerful reminder of the potential for pathogen emergence in new populations. Here the authors use electronic health data collected from two diagnostic laboratories and a network of 392 veterinary premises to describe canine Babesiacases and levels of Babesiaconcern from January 2015 to March 2016, and the activity of ticks during December 2015–March 2016. In most areas of the UK, Babesiadiagnosis in this population was rare and sporadic. In addition, there was a clear focus of Babesiacases in the affected area in Essex. Until February 2016, analysis of health records indicated only sporadic interest in Babesialargely in animals coming from overseas. Following media coverage in March 2016, there was a spike in owner concern that was geographically dispersed beyond the at‐risk area. Tick activity (identified as ticks being removed from animals in veterinary consultations) was consistent but low during the period preceding the infections (<5 ticks/10,000 consultations), but increased in March. This highlights the use of electronic health data to describe rapidly evolving risk and concern that follows the emergence of a pathogen.

A patient is reported who developed lactic acidosis, hyponatraemia and features of the Wernicke-Korsakoff syndrome following long term excessive ingestion of beer and lager. Intramuscular thiamine caused a rapid correction of the lactic acidosis, and the hyponatraemia was corrected by intravenous therapy. On discharge after six weeks of intramuscular Parentrovite the patient still retained some chronic features of the Wernicke-Korsakoff syndrome.

The admissions to Stracathro Hospital due to self poisoning during 1981 have been reviewed and compared with earlier years. Self poisoning is becoming more common and involves a wide age range. Suicide is intended by a high proportion of the subjects.

Hughes K {Department of Social Medicine and Public Health, University of Singapore, Singapore), Foster S O, Tarantola D. Mehta H. Tulloch J L and Joarder A. K. Smallpox surveillance in Bangladesh: II - smallpox facial scar survey assessment and surveillance effectiveness. International Journal of Epidemiology 1980; 9: 335–340. A smallpox facial scar survery of 465 892 persons aged 0–19 years was carried out in Bengladesh in 1976. covering approximately 1% of the 0–19 year old population. Of the 4 306 persons found with facial scarring consistant with previous smallpox infection, none had a history of smallpox with onset after the last reported case on October 16, 1975. Histories taken from persons with facial scars allowed smallpox incidence to be estimated for each year form 1972 to 1975. These estimetes indicate that completeness of reporting increased steedily from 11.8% in 1972 to 83.0% in 1975, reflecting the increasing effectiveness of surveillance.