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Background: There is a general consensus among dental professionals regarding the extraction of impacted third molars in the presence of clinical symptoms. However, there is less agreement on the management of asymptomatic third molars. The objective of this study is to compare the perspectives of oral surgeons and orthodontists regarding the indications for the extraction of asymptomatic third molars. It is possible that healthcare professionals from different specialties may approach the extraction of these teeth in different ways., Methods: In this cross-sectional study, a web-based questionnaire has been employed to collect data by inquiring about the reasons why participants prefer the extraction of asymptomatic third molars. Descriptive statistics were employed to evaluate the data obtained. The level of significance was set at P < 0.05., Results: Prophylactic extraction of partially impacted molars was more favored among the participants (P < 0.05). The orthodontists preferred prophylactic extraction due to the risk of late anterior dental crowding (LADC); however, the oral surgeons preferred pre-pregnancy extractions (P < 0.05). The extraction decision for partial impaction was higher in females when the risk of distal caries was considered. For fully impacted ones, it was higher in males when the risk of caries and pericoronitis were considered (P < 0.05)., Conclusions: Orthodontists preferred extraction because of the risk of LADC and caries, while oral surgeons focused on preventing pericoronitis, pathology, focal infection, and symptoms during pregnancy. This divergence between the participants may inform the guidelines for prophylactic management of third molars. These findings may be pertinent in gender medicine., Clinical Relevance: This study has been enlightening for departments to consult each other before the extraction of a patient's asymptomatic third molar., (© 2024. The Author(s).)

Objective: To investigate the effect of sequential distalization on increasing gaps in the maxillary anterior teeth, focusing on the control of torque and three-dimensional teeth movement during anterior retraction with clear aligners in extraction cases., Methods: We recruited 24 patients who were undergoing extraction bilateral maxillary first premolars with clear aligners. According to a predetermined increment in the spaces between the maxillary anterior teeth, the patients were divided into three groups: those with no gap (9 cases), a 0.5 mm gap (6 cases) and a 1.0 mm gap (9 cases). In each group, a 2.0 mm en-mass retraction was applied on the anterior teeth. Plaster casts of the upper full dentition were obtained both before and after a 2 mm retraction. The palatal folds were used to overlap each pair of models. The three-dimensional movement of the teeth and the change of torque for the anterior teeth were subsequently analyzed using Geomagic Studio 2014 software., Results: The change in torque in the groups with added gaps was significantly smaller than that in the group with no gaps (P < 0.05). There was no significant difference in this respect when comparing the group with a 0.5 mm gap added to the group with a 1.0 mm gap was added (P > 0.05). In the labial-lingual and vertical directions, the displacements of the central and lateral incisors were smaller in the groups with additional gaps compared to those in the groups without gaps (P < 0.05). However, there was no significant difference observed when comparing the group with a 0.5 mm added gap to the group with a 1.0 mm added gap (P > 0.05). Then, a comparison was made between the displacement of the second premolar to the second molar in the mesial-distal direction across all groups. The study revealed that the anchorage molars in the group without gaps demonstrated significantly smaller displacement compared to those in the group with additional gaps (P < 0.05)., Conclusion: Advantages were observed in controlling the torque of the anterior teeth and achieving a desired pattern closer to normal bodily movement by sequentially distalizing the maxillary anterior teeth gaps. Increasing the gaps between the maxillary anterior teeth also resulted in improved control of the vertical direction of the anterior teeth. However, this retraction strategy necessitates substantial protection of the anchorage molars., (© 2024. The Author(s).)

Aim: The correlation between malocclusions in deciduous dentition and type of breastfeeding has been described by many authors in numerous articles. The aim of this article is to investigate the literature about this important topic., Materials: The research was conducted by querying the following databases: PubMed, EBMR, Cochrane Library, Web of Sciences, Medline, Web of Sciences, Ovid and Embase. The key words were: "infant" OR "baby", AND "breastfeeding" AND "malocclusion". As with similar literature review papers, the PRISMA-P (Preferred Reporting Items for Systematic Reviews Protocols) was used. The examined articles were of the following types: randomised controlled trials (RCTs), case-control studies and cohort studies. For the qualitative analysis of the selected studies, it was employed the NOS scale (Newcastle-Ottawa Quality Assessment Scale)., Conclusion: Two hundred and fifty articles were selected. After filtering out the articles deemed irrelevant or with obvious bias, only 16 articles were left. From our results, it can be concluded that breastfeeding seems to play a decisive role in preventing the onset of posterior cross-bites and Class II malocclusions, and that this protective effect appears to be time-dependent.

Background and Objectives : Orthodontics is a field that has seen significant advancements in recent years, with technology playing a crucial role in improving diagnosis and treatment planning. The study aimed to implement artificial intelligence to predict the arch width as a preventive measure to avoid future crowding in growing patients or even in adult patients seeking orthodontic treatment as a tool for orthodontic diagnosis. Materials and Methods : Four hundred and fifty intraoral scan (IOS) images were selected from orthodontic patients seeking treatment in private orthodontic centers. Real inter-canine, inter-premolar, and inter-molar widths were measured digitally. Two of the main machine learning models were used: the Python programming language and machine learning algorithms, implementing the data on k-nearest neighbor and linear regression. Results : After the dataset had been implemented on the two ML algorithms, linear regression and k-nearest neighbor, the evaluation metric shows that KNN gives better prediction accuracy than LR does. The resulting accuracy was around 99%. Conclusions : it is possible to leverage machine learning to enhance orthodontic diagnosis and treatment planning by predicting linear dental arch measurements and preventing anterior segment malocclusion.

Objectives: To investigate the effect of three interceptive measures (slow maxillary expansion (SME) with removable plates (1), extraction of both upper deciduous canines (DC) (2) and no intervention (3)) on maxillary canine (MC) position in patients with early mixed dentition (EMD) and lack of upper arch space. These three groups were additionally compared to a control group (4) with adequate upper arch space., Null Hypothesis: None of the studied strategies outperforms the others regarding improvement of MC position., Trial Design: Four-arm parallel group prospective randomized controlled trial., Participants: Patients in EMD with at least one impacted MC, non-resorbed DC, and no crossbite., Interventions: Patients with a lack of space were randomly distributed to protocols (1), (2), and (3)., Primary Objective: To assess the change in MC position after 18 months follow up., Secondary Objectives: To assess canine eruption and need for orthodontic intervention within 18-60 month follow up., Outcome Assessment: Five variables defined canine position: sector, canine-to-midline angle, canine-to-first-premolar angle, canine-cusp-to-midline distance, and canine-cusp-to-occlusal-plane distance on two panoramic radiographs at 0 (T1) and 18 months (T2). Mean differences between groups were compared with linear mixed models, corrected for age and sex., Randomization: The patient allocation sequence was generated by an electronic randomization list., Blinding: The operator taking the measurements was blinded to the groups., Results: Seventy-six patients were included (142 canines, mean age 9.2 years, 60.5 per cent male, mean follow up 1.9 years), 19, 17, 14, and 26 patients in groups 1-4, respectively. In absence of dental crossbite in patients with lack of space and impacted MC, SME improved the canine sector (P = 0.040), compared to no intervention (P = 0.028). Canine-to-midline angle and canine-to-occlusal-plane distance significantly decreased in all groups at T2. Extraction improved the canine-to-first-premolar angle at T2 more than other strategies in EMD (P = 0.015-0.000)., Conclusions: Early SME improves the canine sector and reduces the need for major orthodontic intervention in the long term. Taking a first panoramic radiograph in EMD allows timely intervention in case of MC impaction., Trial Registration Number: NCT05629312 (Clinical Trials.org). Trial status: follow up ongoing., (© The Author(s) 2023. Published by Oxford University Press on behalf of the European Orthodontic Society. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

It is widely recognised by the scientific dental community that the correct development of the deciduous and mixed dentitions is paramount to the oral health of paediatric patients. In this respect, interceptive orthodontics plays a fundamental role in the process. Specifically, the paediatric dentist monitors the condition of the mouth from early childhood, distinguishing three age brackets for intervention, each defined by their own characteristics. It would also be desirable for other professionals who treat young patients and their mothers to various extents, such as paediatricians, gynaecologists, obstetricians and speech therapists to share valuable information with us. What follows is a brief summary of important conditions and key information regarding interceptive orthodontics. Age range 0-3 years: breastfeeding during the first months of life has been shown to have a positive effect on the development of the jaws. Later on, the transition to solid food, promoted by the eruption of the deciduous teeth, further stimulates their growth. During this phase, it is recommended to monitor and intercept any muscular hypotonia and low tongue postures. Additionally, it is essential to instruct parents on the proper dietary and lifestyle behaviours needed to ensure the physiological growth of the child, while protecting the health of their oral cavity. Age range 4-6 years: attention should be paid to the deciduous dentition and the development of the upper and lower maxillary bones, along with prompt interception and correction of bad habits such as the continued use of the pacifier, finger sucking, oral breathing and atypical swallowing. Age >6 years: within this phase, the careful monitoring of the space available in the arch, the natural exfoliation of milk teeth, the eruption of the permanent teeth and their occlusal relationship, as well as the maxillomandibular relationship are all important. If necessary, in addition to removing any risk factor, fixed or mobile orthodontic appliances can also be used during the above stages, especially stage 2 and 3, depending on the occlusal and skeletal status of the patient. Early diagnosis of malocclusion is crucial, as well as the sharing of information with other clinicians that deal with children and their parents, who need to be informed about the various therapies that their child may need. The paediatric dentist could, in fact, directly reach out to families to make them understand that malocclusion and other manifestations linked to conditions affecting oral functions such as breathing, sleeping, chewing and feeding often show the first signs as early as pre-school age, long before eruption of the first milk tooth, which is the time when the first dental visit is usually booked! We trust that awareness is the first form of prevention, and this is the message that must be conveyed to all of those involved in paediatric dentistry, patients and professionals alike: awareness and prevention is the first cure.

Aim: Malocclusion is an alteration of the normal relationships between skeletal, muscle and dental structures that can lead to impaired functionality as well as aesthetic alteration of the stomatognathic system. Functional alteration can affect various aspects, ranging from chewing ability to respiratory disorders. Paediatricians and dentists are called to prevent and diagnose these conditions as early as possible in order to preserve the patient's health. The purpose of this research is to study the incidence of malocclusion and its relationship with Obstructive Sleep Apnea Syndrome (OSAS) in a young population. Also, the role of paediatricians and dentists in prevention and early diagnosis of this condition was evaluated METHODS: An anonymous survey was given through Google form to 300 Italian children (139 males and 161 females) from different private dental practices in Italy. No personal information that identifies the individuals was collected, and the data was analysed in aggregate form only. All data was collected and statistically analysed., Conclusion: The data highlight the patients' good attitude towards dental check-ups, which help to intercept malocclusions. Unlike the past, the knowledge of the importance of oral health and dental occlusion is high among young patients, parents and paediatricians. This study underlines the role of paediatricians as key players in the prevention of dental health problems.

Malocclusion is one of the three most common oral diseases reported by World Health Organization(WHO). In China, its incidence rate is rising. Malocclusion seriously affects the dental and maxillofacial function, facial appearance and growth development of nearly 260 million children in China, and what is more, it affects their physical and mental health development. Malocclusion occurrence is related to genetic and environmental factors. Early treatment of malocclusion can create a good dental and maxillofacial development environment, correct abnormal growth and control the adverse effects of abnormal genetic factors. It can effectively reduce the prevalence of children's malocclusion and enhance their physical and mental health. This is an urgent need from the economic perspective of our society, so it has great practical and social significance. Experts from the project group "standard diagnose and treatment protocols for early orthodontic intervention of malocclusions of children" which initiated by China National Health Institute of Hospital Administration wrote the "China Experts' Consensus on Preventive and Interceptive Orthodontic Treatments of Malocclusions of Children", which aims to guide and popularize the clinical practice, improve the clinical theory and practice level, and accelerate the disciplinary development of early treatment of children's malocclusion in China. The consensus elaborates the harmfulness of malocclusion and the necessity of early treatment, and brings up the principles and fundamental contents. Based on the law of dental and maxillofacial development, this paper puts forward the guiding suggestions of preventive and interceptive treatments in different stages of dental development ranging from fetus to early permanent dentition. It is a systematic project to promote and standardize the early treatment of malocclusion. Through scientific and comprehensive stratified clinical practice and professional training, the clinical system of early treatment of malocclusion in China will eventually be perfected, so as to comprehensively care for children's dental and maxillofacial health, and improve their oral and physical health in China.

The current study aimed to find a prediction equation to estimate the arch perimeter (AP) depending on various arch dimensions including intercanine width (ICW), intermolar width (IMW), interpremolar width (IPMW), and arch length (AL) in a sample of the Kurdish population in Sulaimani City. The study sample was 100 pairs of preorthodontic dental casts. Calculations of dental arch dimensions and perimeter were performed by a digital vernier. Statistical analysis was performed via using the SPSS version 25 software. The developed prediction equation for the upper arch was Y = +1.3 × (arch length) + 1 × (intermolar width), whereas the equation for the lower arch was Y = +0.9 × (intermolar width) + 0.92 × (intercanine width). Paired t -test revealed no statistical difference between predicted and real arch perimeters. Two separate prediction equations for upper and lower arches were developed based on the arch length (AL) and intermolar width (IMW) for the maxillary arch, intermolar (IMW), and inter canine widths (ICW) for the lower arch. The developed equations could have further beneficial impacts on orthodontic diagnosis and treatment planning., Competing Interests: The authors declare that they have no competing interests., (Copyright © 2020 Fadil Abdullah Kareem et al.)

Background: The purpose of this systematic review was to analyze the available literature about the influence of breastfeeding in primary and mixed dentition on different types of malocclusions., Methods: Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) guidelines were used to perform the present review. The following electronic databases were searched: Pubmed, Evidence-Based Medicine Reviews (EBMR), Embase, Cochrane Library, Medline, Web of Science and Ovid., Results: A primary research found a total of 279 articles. Two more papers were also considered from the gray literature. Two hundred sixty-three articles were excluded as they were deemed irrelevant on the basis of: duplicates, title, abstract, methods and/or irrelevant contents. Eighteen papers were selected and included in the qualitative analysis., Conclusions: breastfeeding is a positive factor that seems to reduce the incidence of posterior crossbite, skeletal class II and distoclusion in primary and mixed dentition. A sort of positive relationship between months of breastfeeding and risk reduction seems to exist. More longitudinal research is needed to avoid bias in the results, with data collected prospectively on the months of exclusive breastfeeding, by means of specific questionnaires and successive clinical evaluation of the occlusal condition at the primary dentition, mixed dentition and permanent dentition stages.

Objective: To compare and evaluate the relapse tendency of two types of fixed lingual retainers using Little's irregularity index for a follow-up of one year., Study Design: Randomised clinical trial., Place and Duration of Study: Department of Orthodontics, Dr. Ishrat Ul Ebad Khan Institute of Oral Health Sciences and Dow Dental College in Dow University of Health Sciences, Karachi, Pakistan, from November 2017 to March 2019., Methodology: A total of 54 patients were recruited and divided into two groups by random allocation. Subjects who have completed fixed appliance (MBT) orthodontic treatment and non extraction cases with moderate crowding in the lower arch were included. Subjects with caries, restoration, fracture or missing lower anterior teeth were excluded. Group 1 received fiber reinforced composite (FRC) retainers and group 2 received multistranded stainless steel (MSW) retainers. They were recalled after every three months interval for one year. Relapse tendency of retainers using Little's irregularity index was evaluated at each visit., Results: Comparison of relapse tendency between two retainers showed statistically significant results (p<0.05). The mean difference of CPD between two retainers at T0 was found to be 0.09 mm (p=0.01). At T1, it was determined to be 0.3 mm (p=0.022), and at T2 it was found to be 0.3 mm (p=0.008). At T3 and T4, it was found to be 0.5 mm (p<0.001) and 0.5 mm (p=0.002), respectively. All mean differences were statistically significant., Conclusion: Fiber-reinforced retainers are more effective in preventing the mandibular incisor relapse. The results of the study also suggest that the irregularity of the dentition increases with the passage of time.

Occlusal assessments are often missed or neglected by dentists and dental hygienists. This short communication discusses how these assessments can be implemented through 4 planes of space: anterior-posterior/anteroposterior, vertical, transverse, and perimeter. Expanded occlusal knowledge can improve the referral process for early preventive care. A chairside guide has been defined for dental hygienists to conduct a systematic occlusal exam., Competing Interests: The authors have no affiliations or involvement in any organizations with any financial or non-financial interests in this research., (Copyright © 2019, CDHA | ACHD.)

Dental and stomatologic problems in childhood need to be diagnosed and managed with multidisciplinary protocols focusing around the children an appropriate prevention, diagnosis, and care program. Therefore, it is paramount to avail of screening tools that provide an indication of in-depth multidisciplinary diagnostic flow. The aim of this study is to detect and evaluate malocclusion problems and predisposing factors in an Italian preschooler population. Design-calibrated operators detected data through examination of 1,405 children (706 males and 699 females) aged between 2 and 7 years, in one hospital in Rome and in kindergartens of several Italian cities. Data were collected following Risk of Malocclusion Assessment index criteria. Pearson's chi-square test (with continuity correction) and Fisher's exact test were the statistical tests conducted ( P  < 0.05). Grade 2 (49.6%) and 4 (21.7%), followed by grade 1 (17.1%), grade 3 (9.3%), and finally grade 5 (2.3%) are the most represented degrees. 53.6% of the cases have a high risk, whereas 32.2% has a low risk and 14.9% has a moderate risk. The risk-degree correlation is statistically significant ( P  < 0.005). Flawed habits and oral breathing are present in more than a quarter of children. Findings of the study highlighted that early multidisciplinary approach, as well as orthodontic visits and screening in childhood, is necessary to promote normal growth and development of the face and the elimination of potential interferences that may harm these processes., Competing Interests: The authors declare they have no conflict of interest.

Background: Over the years, the treatment to be chosen for the resolution of condylar fractures has been discussed with great concern. Treatment depends on the type and location of the fracture, as well as other associated factors such as facial injuries and concurrent diseases., Aim of the Study: The aim of the study was to make a review of the different criteria to establish a diagnosis and treatment to resolve mandibular condyle fractures, according to the evolution of the years and what this entails., Discussion: Management of condylar fractures remains controversial among surgeons. However, as time goes by and as comparative and analytical studies are carried out within the issue, parameters and criteria are established to facilitate the decisions taken regarding the management and treatment of condylar fractures., Conclusion: Condylar fractures must be managed according to the clinical and case presentation., (Copyright: © 2019 Permanyer.)

22q11.2 deletion syndrome (22q11.2DS) is one of the most common microdeletion syndromes, with an incidence of approximately 1/2000-1/4000 live births; it is thought to be mainly attributable to a de novo deletion. The clinical phenotype of this syndrome is highly variable. Certain craniofacial and oral features are common to most patients with 22q11.2DS, including a high prevalence of dental caries; abnormalities of tooth shape, eruption and number; and enamel defects such as hypomineralisation and hypoplasia. This report focuses on the dental features and management of an 8-year-old boy with 22q11.2DS. Dental treatments were carried out under general anaesthesia. In summary, facial dysmorphism and common dental manifestations are typically noticeable in patients with this syndrome. Therefore, dentists need to be aware of the dental features of this condition in order to refer them to the adequate specialists. Cooperation among and experience with different specialties are mandatory to improve quality of life for patients with 22q11.2DS., Competing Interests: Competing interests: None declared., (© BMJ Publishing Group Limited 2018. No commercial re-use. See rights and permissions. Published by BMJ.)

Malocclusion is a worldwide dental problem that influences the affected individuals to varying degrees. Many factors contribute to the anomaly in dentition, including hereditary and environmental aspects. Dental caries, pulpal and periapical lesions, dental trauma, abnormality of development, and oral habits are most common dental diseases in children that strongly relate to malocclusion. Management of oral health in the early childhood stage is carried out in clinic work of pediatric dentistry to minimize the unwanted effect of these diseases on dentition. This article highlights these diseases and their impacts on malocclusion in sequence. Prevention, treatment, and management of these conditions are also illustrated in order to achieve successful oral health for children and adolescents, even for their adult stage.

The aim of the present study was to obtain the prevalence of malocclusions in preschool children in Shanghai, China. A cross-sectional survey was conducted among 2335 children aged 3-5 years from kindergartens. Several occlusal parameters were clinically assessed, including second deciduous molar terminal plane, canine relationship, degree of overjet and overbite, anterior and posterior crossbite, and the presence or absence of physiologic spaces and crowding. All parents of subjects were asked to fill in the oral health knowledge questionnaires. The prevalence of malocclusion in primary dentition in Shanghai was 83.9%, and no significant differences were found in genders. Data showed that the prevalence of deep overbite (63.7%) was the highest in children with malocclusion, followed by deep overjet (33.9%), midline deviation (26.6%), anterior crossbite (8.0%) and anterior crowding (6.5%). The results revealed a high prevalence of malocclusion in primary dentition in children aged 3-5 years old of Shanghai, especially in vertical anomalies. The need for preventive orthodontic therapy is extremely desired and oral health education about malocclusion should be strengthened.

Introduction: The early loss of deciduous molars is a frequently encountered problem in dentistry. Various space maintainer designs were developed to prevent the loss of the space. The aim of this study was to evaluate long-term clinical performance and survival rates of fiber-reinforced composite resin (FRCR) as a space maintainer clinically., Materials and Methods: This study was designed on 44 children who had early missed deciduous molars. Space maintainers were prepared on plaster models of patients and fixed directly to the adjacent teeth. Survival rate and whether it causes any damage to adjacent teeth were examined clinically and radio-graphically for 24 months or until failure. Kaplan-Meier survival analysis was used for the statistical analyses., Results: Overall, 16.2% of space maintainers were dislodged and accepted to be failed at the end of 12 months. At the 24-month control, 52.2% success was stated with the FRCR space maintainer and because of permanent tooth eruption, 31.8% of space maintainer were taken out. The mean duration of space maintainers was measured to be 14.8 ± 3.48 months. There was no statistical significance between survival time and gender, tooth number, localization, and measured space (p > 0.05)., Conclusion: After all 24 months follow-up, as well as esthetic properties of FRCR space maintainer, their applicability in a single seance and strength against the forces are determined as the advantages of the technique., Clinical Significance: The FRCR space maintainers can be thought of as alternatives to metal space maintainers.

Data sourcesCochrane Oral Health Group's Trials Register, Cochrane Central Register of Controlled Trials (CENTRAL), Medline, Embase, US National Institutes of Health Trials Registry and The World Health Organization (WHO) Clinical Trials Registry Platform, abstracts from the British Orthodontic Conference, the European Orthodontic Conference and the International Association for Dental Research (IADR) from 2011 to 2015 and the bibliographies of identified studies.Study selectionRandomised controlled trials (RCTs) involving children and adults who had had retainers fitted or adjunctive procedures undertaken to prevent relapse following orthodontic treatment with braces were considered.Data extraction and synthesisTwo reviewers independently selected studies, abstracted data and assessed study quality. For continuous data mean differences (MD) with 95% confidence intervals (CI) were calculated with ratios (RR) and 95% CI for dichotomous outcomes.ResultsFifteen studies involving a total of 1722 patients were included. Seven studies were considered to be at high risk of bias, four at low risk and four at unclear risk. For removable retainers versus fixed retainers (three studies) there was low quality evidence that thermoplastic removable retainers provided slightly poorer stability in the lower arch than multistrand fixed retainers: MD (Little's Irregularity Index, 0 mm is stable) 0.6 mm (95% CI 0.17 to 1.03) and of less gingival bleeding with removable retainers: RR 0.53 (95%CI; 0.31 to 0.88). Patients found fixed retainers more acceptable to wear, with a mean difference on a visual analogue scale (VAS; 0 to 100; 100 being very satisfied) of -12.84 (95% CI -7.09 to -18.60).For different types of fixed retainers (four studies) data from three studies (228 patients) comparing polyethylene ribbon bonded retainer versus multistrand retainer were pooled showing no evidence of a difference in failure rates. RR = 1.10 (95%CI; 0.77 to 1.57).Pooled data from two trials (174 patients) comparing the same types of upper fixed retainers, showed a similar finding: RR =1.25 (95%CI; 0.87 to 1.78).For different types of removable retainers (eight studies) one study at low risk of bias comparing upper and lower part-time thermoplastic versus full-time thermoplastic retainers showed no evidence of a difference in relapse (graded moderate quality evidence). Another study, comparing part-time and full-time wear of lower Hawley retainers, found no evidence of any difference in relapse (low quality evidence). Two studies at high risk of bias suggested that stability was better in the lower arch for thermoplastic retainers versus Hawley, and for thermoplastic full-time versus Begg (fulltime) (both low quality evidence). In one study, participants wearing Hawley retainers reported more embarrassment more often than participants wearing thermoplastic retainers: RR 2.42 (95% CI 1.30 to 4.49; one trial, 348 participants, high risk of bias, low quality evidence). They also found Hawley retainers harder to wear. There was conflicting evidence about survival rates of Hawley and thermoplastic retainers.For combination of upper thermoplastic and lower bonded versus upper thermoplastic with lower adjunctive procedures versus positioner (one study) there was no evidence of a difference in relapse between the combination of an upper thermoplastic and lower canine to canine bonded retainer and the combination of an upper thermoplastic retainer and lower interproximal stripping, without a lower retainer. Both these approaches are better than using a positioner as a retainer.ConclusionsWe did not find any evidence that wearing thermoplastic retainers fulltime provides greater stability than wearing them part-time, but this was assessed in only a small number of participants. Overall, there is insufficient high quality evidence to make recommendations on retention procedures for stabilising tooth position after treatment with orthodontic braces. Further high quality RCTs are needed.

Results: 506 of the 802 guardians/children referred to the PPM joined. As for the children, the most frequently assessed habits were: bottle (56.1%), bottle and pacifier (18.4%), finger (11.9%), bottle and finger (7.1%), pacifier (5.7%), pacifier and finger (0.6%), and bottle/pacifier/finger (0.2%). After parent participation in the meetings, 335 (66.2%) children abandoned their habits. There was a statistical difference between type of oral habit and time to abandonment (p = 0.0001). However, those with only one habit abandoned it more easily (72.6%) than those with two or more associated habits (48.1%) (p = 0.042). Presence or absence of breastfeeding and parents' level of education had no significant effect on habit abandonment., Conclusion: PPM was an important tool for spreading knowledge to guardians, greatly contributing to the abandonment of deleterious oral habits. Bottle sucking warrants special attention - mentioned by 81.8% of parents - either alone or associated with other habits. Thus, educational actions to implement the children's approach to oral health are fundamental to making behavioral changes and promoting education of healthy habits, thereby keeping malocclusions from developing.

Objective: Malocclusion is a highly prevalent condition, affecting 20-60% of adolescents worldwide. Although its treatment is often expensive and unaffordable for disadvantaged individuals, few studies have examined the relationship between malocclusion and socioeconomic status. We investigated the prevalence of malocclusion among Mongolian adolescents and its association with maternal education in a community-based sample in Mongolia., Design: Cross-sectional study., Settings: 2 large secondary schools with different backgrounds in Ulaanbaatar, Mongolia., Participants: Complete dental casts of 557 randomly recruited Mongolian schoolchildren aged 11-16 years were evaluated using the Dental Health Component of the Index of Orthodontic Treatment Need to dichotomise orthodontic treatment requirements. Exclusion criteria were the presence of orthodontic treatment history and absence of maternal educational status. Questionnaires were administered to caregivers to assess socioeconomic status. Poisson regression analysis was performed to examine the association between malocclusion and maternal educational status., Results: The prevalence of malocclusion requiring orthodontic treatment among all adolescents was 35.2% (95% CI 31.2 to 39.2). In the unadjusted analysis, the prevalence ratio (PR) for malocclusion was higher (PR=1.46; 95% CI 0.96 to 2.20) among adolescents of mothers with a high educational background than among those of mothers with a low educational background. After adjusting for covariates, the PR remained significantly higher (PR=1.72; 95% CI 1.06 to 2.82) among adolescents of mothers with a high educational background. Other socioeconomic status variables, including family income and the educational level of the father, showed no association with malocclusion., Conclusions: These findings suggest that malocclusion requiring orthodontic treatment in adolescents is more prevalent among children of mothers with high levels of education. Further studies are needed to clarify the behavioural factors and environmental circumstance that contribute to this., Competing Interests: Conflicts of Interest: None declared., (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.)

Aim: The aim of the present work is to investigate whether dental decoronation is a procedure known by a sample of dental students and Italian dentists. Dental decoronation technique is performed in order to mitigate the outcomes which may occur after a delayed tooth replantation., Materials and Methods: A cognitive survey about the knowledge of the dental decoronation technique was carried on two groups: a sample of 120 dental students (5th year of dental school), from University of Cagliari, Sassari and of Chieti-Pescara (60 males and 60 females), and a group which involved 200 Italian dentists (age comprised between 25 and 45, 130 females and 70 males) enrolled at pedodontics and orthodontics Masters and CE courses (University of Roma Sapienza, Chieti- Pescara, Cagliari). The latter group's main field of work was paediatric dentistry and orthodontics, two dental specialties often involved in treating Traumatic dental injuries., Results: Only 20 dentists out of the 200 interviewed answered that they knew this technique and only 5 of them proved to know it and were able to describe it correctly. No students interviewed knew this technique., Conclusion: It is apparent from the results of this survey that there is very little information about the dental decoronation technique both during the Degree Course in Dentistry and Post Graduate specialty programmes (Continuing Education Courses and Masters).

Aim: The purpose of the study was to evaluate the efficacy of the guidelines on oral health published by the Italian Health Ministry., Study Design: 1239 patients (582 girls and 657 boys) with a mean age of 4.46 (SD 2.81) years were evaluated before application of the guidelines by paediatricians (T0) for the presence of caries, gingivitis, diseases of the oral mucosa, and malocclusion. Only patients aged 6 months, 3 years, 6 years, and 9 years at T0 were taken into consideration. All patients were reevaluated after application of the ministerial guidelines (T1)., Methods: the study took place over a 3-year period. Enrolled patients referred to the outpatient clinics of three paediatricians of the Province of Genoa who strictly applied the ministerial guidelines., Statistics: Chi square test analysis was performed to evaluate a statistically significant decrease in the incidence of caries, gingivitis and diseases of the oral mucosa., Results: After a 3-year follow-up collected data underlined a statistically significant decrease in the incidence of dental caries, gingivitis and oral mucosal diseases after implementation of the recommended ministerial guidelines. A statistically significant decrease of malocclusions was also evident in the elder patients (12 years old at T1)., Conclusion: The accurate implementation of the Guidelines is supported. Only collaboration and increased synergy between paedodontists and paediatricians can fulfill the objectives which were the reason for publishing the "National guidelines for the promotion of oral health and the prevention of oral diseases in developmental age".

Background: Comforting behaviours, such as the use of pacifiers (dummies, soothers), blankets and finger or thumb sucking, are common in babies and young children. These comforting habits, which can be referred to collectively as 'non-nutritive sucking habits' (NNSHs), tend to stop as children get older, under their own impetus or with support from parents and carers. However, if the habit continues whilst the permanent dentition is becoming established, it can contribute to, or cause, development of a malocclusion (abnormal bite). A diverse variety of approaches has been used to help children with stopping a NNSH. These include advice, removal of the comforting object, fitting an orthodontic appliance to interfere with the habit, application of an aversive taste to the digit or behaviour modification techniques. Some of these interventions are easier to apply than others and less disturbing for the child and their parent; some are more applicable to a particular type of habit. , Objectives: The primary objective of the review was to evaluate the effects of different interventions for cessation of NNSHs in children. The secondary objectives were to determine which interventions work most quickly and are the most effective in terms of child and parent- or carer-centred outcomes of least discomfort and psychological distress from the intervention, as well as the dental measures of malocclusion (reduction in anterior open bite, overjet and correction of posterior crossbite) and cost-effectiveness., Search Methods: We searched the following electronic databases: the Cochrane Oral Health Group Trials Register (to 8 October 2014), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2014, Issue 9), MEDLINE via OVID (1946 to 8 October 2014), EMBASE via OVID (1980 to 8 October 2014), PsycINFO via OVID (1980 to 8 October 2014) and CINAHL via EBSCO (1937 to 8 October 2014), the US National Institutes of Health Trials Register (Clinical Trials.gov) (to 8 October 2014) and the WHO International Clinical Trials Registry Platform (to 8 October 2014). There were no restrictions regarding language or date of publication in the searches of the electronic databases. We screened reference lists from relevant articles and contacted authors of eligible studies for further information where necessary., Selection Criteria: Randomised or quasi-randomised controlled trials in children with a non-nutritive sucking habit that compared one intervention with another intervention or a no-intervention control group. The primary outcome of interest was cessation of the habit., Data Collection and Analysis: We used standard methodological procedures expected by The Cochrane Collaboration. Three review authors were involved in screening the records identified; two undertook data extraction, two assessed risk of bias and two assessed overall quality of the evidence base. Most of the data could not be combined and only one meta-analysis could be carried out., Main Results: We included six trials, which recruited 252 children (aged two and a half to 18 years), but presented follow-up data on only 246 children. Digit sucking was the only NNSH assessed in the studies. Five studies compared single or multiple interventions with a no-intervention or waiting list control group and one study made a head-to-head comparison. All the studies were at high risk of bias due to major limitations in methodology and reporting. There were small numbers of participants in the studies (20 to 38 participants per study) and follow-up times ranged from one to 36 months. Short-term outcomes were observed under one year post intervention and long-term outcomes were observed at one year or more post intervention. Orthodontics appliance (with or without psychological intervention) versus no treatmentTwo trials that assessed this comparison evaluated our primary outcome of cessation of habit. One of the trials evaluated palatal crib and one used a mix of palatal cribs and arches. Both trials were at high risk of bias. The orthodontic appliance was more likely to stop digit sucking than no treatment, whether it was used over the short term (risk ratio (RR) 6.53, 95% confidence interval (CI) 1.67 to 25.53; two trials, 70 participants) or long term (RR 5.81, 95% CI 1.49 to 22.66; one trial, 37 participants) or used in combination with a psychological intervention (RR 6.36, 95% CI 0.97 to 41.96; one trial, 32 participants). Psychological intervention versus no treatmentTwo trials (78 participants) at high risk of bias evaluated positive reinforcement (alone or in combination with gaining the child's co-operation) or negative reinforcement compared with no treatment. Pooling of data showed a statistically significant difference in favour of the psychological interventions in the short term (RR 6.16, 95% CI 1.18 to 32.10; I(2) = 0%). One study, with data from 57 participants, reported on the long-term effect of positive and negative reinforcement on sucking cessation and found a statistically significant difference in favour of the psychological interventions (RR 6.25, 95% CI 1.65 to 23.65). Head-to-head comparisonsOnly one trial demonstrated a clear difference in effectiveness between different active interventions. This trial, which had only 22 participants, found a higher likelihood of cessation of habit with palatal crib than palatal arch (RR 0.13, 95% CI 0.03 to 0.59)., Authors' Conclusions: This review found low quality evidence that orthodontic appliances (palatal arch and palatal crib) and psychological interventions (including positive and negative reinforcement) are effective at improving sucking cessation in children. There is very low quality evidence that palatal crib is more effective than palatal arch. This review has highlighted the need for high quality trials evaluating interventions to stop non-nutritive sucking habits to be conducted and the need for a consolidated, standardised approach to reporting outcomes in these trials.

The World Health Organization recommends exclusive breast feeding for at least six months. However, there is no scientific evidence of the benefits of breast feeding for oral health in children under primary dentition. This study aimed to search for scientific evidence regarding the following question: is bottle feeding associated with malocclusion in the primary dentition compared to children that are breastfed? An electronic search was performed in seven databases. The systematic review included 10 cohort studies. It was not possible to conduct meta-analysis; therefore a qualitative analysis was assessed. The majority of studies evaluated feeding habits by means of questionnaires and conducted a single examination. Three studies observed that bottle feeding was significantly associated with overjet and posterior crossbite. Studies reported several cut-off times for breastfeeding (varying from 1 month up to 3 years of age) and several types of malocclusion. Controlling for non-nutritive sucking habits was reported for only half of the studies and this may have led to biased results. The scientific evidence could not confirm a specific type of malocclusion associated with the feeding habits or an adequate time of breastfeeding to benefit the children against malocclusion. Further cohort studies are needed to confirm this evidence.

As most of the etiologic factors of malocclusion are of genetic origin and thus cannot be prevented, environmental causative factors have become the focus for correction. Early interception of oral habits may be an important step in order to prevent occlusal disturbances in children. The identification of an abnormal habit and the assessment of its potential immediate and long-term effects on the dentition and potentially on the craniofacial complex should be made at an early stage. This paper focuses on the most common oral habits influencing dentofacial growth in childhood and management of these habits in the developing dentition.

Background: The role of third molars as a cause of incisor crowding, especially in the lower arch, continues to be controversial. The aim of this work is to compare opinions of Italian oral surgeons and orthodontists on this topic., Methods: One hundred ninety-three Italian practitioners of the Society of Orthodontics (SIDO) and the Italian Society of Oral Surgery (SICOI) were asked to fill out an online questionnaire made up of six questions. Practitioners were asked to express their opinion on the relation between upper and lower third molar eruption and anterior crowding., Results: One hundred sixty-six members of both societies completed the online research survey; response rate (RR) was 86%. There were no statistically significant differences between the two groups (P > 0.005). Both agree not to believe that third molars create a force responsible for anterior crowding in the upper (82.5% orthodontists, 83.8% surgeons) and in the lower arch (52.6% orthodontists, 63.8% surgeons). Both agree also not to consider the upper (89.7% orthodontists, 82.1% surgeons) and lower (58.8% orthodontists, 63.2% surgeons) third molar extraction useful to prevent crowding., Conclusions: Italian orthodontists and oral surgeons have the same opinion on the role of the third molar in causing anterior crowding. The majority of both groups of clinicians do not consider their preventive extraction useful in order to prevent anterior crowding.

Premature loss of primary teeth can result in a loss of arch length and have a negative effect on occlusion and alignment, often increasing the need for orthodontic treatment. Use of space maintainers can reduce the severity of problems such as crowding, ectopic eruption, tooth impaction and poor molar relationship. This article presents a review of the consequences of premature tooth loss and discusses the appliances commonly used for space maintenance.

Aims: To measure the friction force generated during sliding mechanics with conventional, self-ligating (Damon 3 mx, Smart Clip, and Time 3) and low-friction (Synergy) brackets using different archwire diameters and ligating systems in the presence of apical and buccal malalignments of the canine., Methods: An experimental setup reproducing the right buccal segment of the maxillary arch was designed to measure the friction force generated at the bracket/wire and wire/ligature interfaces of different brackets. A complete factorial plan was drawn up and a three-way analysis of variance (ANOVA) was carried out to investigate whether the following factors affect the values of friction force: (i) degree of malalignment, (ii) diameter of the orthodontic wire, and (iii) bracket/ligature combination. Tukey post hoc test was also conducted to evaluate any statistically significant differences between the bracket/ligature combinations analyzed., Results: ANOVA showed that all the above factors affect the friction force values. The friction force released during sliding mechanics with conventional brackets is about 5-6times higher than that released with the other investigated brackets. A quasilinear increase of the frictional forces was observed for increasing amounts of apical and buccal malalignments., Conclusion: The Synergy bracket with silicone ligature placed around the inner tie-wings appears to yield the best performance.

The purpose of this study was to investigate the outcome of early interceptive treatment of primary anterior crossbites with posterior occlusal acrylic resin blocks in combination with a 2 × 4 appliance, and to examine the differences in craniofacial morphology between the stable and relapse groups. Lateral cephalograms of 46 subjects (17 males and 29 females; average mean age 4 years 2 months ± 5 months) with a primary anterior crossbite were obtained before (T0) and immediately after (T1) treatment and at a 6 year follow-up (T2). The patients were assigned to either a stable (n = 35; 13 males and 22 females) or a relapse (n = 11; 4 males and 7 females) group according to the amount of overjet when the permanent incisors had erupted. The differences in craniofacial morphology between the groups were compared using a two-tailed t-test. The results revealed that the relapse subjects had a more forward position of the mandible relative to the cranial base and maxilla, a longer mandible and an increased gonial angle at T0. At T1, both groups had a positive overjet, but the treatment changes were different. Between T1 and T2, the maxillary length (A'-Ptm') increased less in the relapse group, the angle between the posterior border of the mandibular ramus and SN plane (Ram-SN) decreased and gonial angle increased and vice versa in the stable group. When posterior bite raising and 2 × 4 appliance therapy are used to correct primary anterior crossbites, all patients showed an immediate positive treatment response, whereas approximately one-quarter of subjects relapsed into a reverse overjet when the permanent incisors had erupted, mainly because of a more severe Class III craniofacial morphology at T1 and unfavourable growth during T1-T2.

Unlabelled: Children with hypertrophic tonsils and adenoids may have adverse effects on dental occlusion, which tend to worsen during the growth period. Diagnosis and early treatment is essential., Aim: Prospective clinical study to compare the cephalometric measurements before and after adenotonsillectomy in mouth breathing patients., Material and Method: We had 38 patients of both genders, aged between 7 and 11 years in our sample, broken down into: oral group, 18 patients with obstructive hypertrophy of pharyngeal tonsil and/or palate grade 3 or 4; control group, 20 patients with normal breathing. Angular and linear dental measurements were compared between the groups in a 14 months interval. We used the "t" Student and Wilcoxon tests for unpaired samples, at 5% significance, for statistical purposes., Results: The sagittal position and axial angle of the lower incisors increased significantly in the group with oral breathing, the sagittal position of the upper incisors increased significantly in the oral group, which still had a significant increase in overbite., Conclusion: Adenotonsillectomy was very effective in improving some dental measurements, with benefits to growing patients preventing malocclusions from becoming difficult to treat or permanent.

The aim of this prospective study was to evaluate the number of contacts in centric occlusion during retention with thermoplastic retainers (Essix retainers) and in the long term. After four premolar extractions and active orthodontic treatment of 15 Class I (10 females, 5 males; mean age 17.20 +/- 1.7 years), thermoplastic retainers were used. Occlusal contacts were determined from occlusal registrations taken in centric occlusion at the beginning (T0), end (9 months of retention; T1), and after 2.5 years (T2). The occlusal contacts determined in these patients were compared with the values of 15 'normal' Class I subjects (9 females, 6 males; mean age 17.10 +/- 1.60 years) who had not undergone orthodontic treatment. Wilcoxon and a Mann-Whitney U-tests were used to evaluate intra- and intergroup differences. No significant change was observed in the number of posterior contacts during T1, whereas a significant increase was found at T2 (P < 0.01) for the second premolars (P < 0.01) and second molars (P < 0.05). Both 'ideal' and 'non-ideal' contacts increased significantly but only at T2 (P < 0.05). The number of ideally located contacts on the posterior teeth at all three periods were lower than normal values (P < 0.01); while non-ideal contacts at T1 (P < 0.05) and T2 (P < 0.01) were found more often when compared with the values of normal subjects. Only the increased number of premolar contacts at T2 was more than normal values (P < 0.01). There was no expected increase in occlusal contacts at T2; however, posterior occlusal contacts were increased at T3.

The purpose of this study was to determine whether thermoplastic retainers need to be worn full-time for a limited period or whether part-time wear from the outset is adequate to maintain tooth position, arch form, and occlusion. This study was a randomized clinical trail, conducted in a district general hospital. Sixty-two participants were enrolled in the study. Group 1, full-time wear, consisted of 30 patients (12 males and 18 females, aged 13.6 +/- 1.5 years) and group 2, part-time wear, 32 patients (14 males and 18 females, aged 13.8 +/- 1.5 years). Each patient was assigned to one of the groups by random number generation. Clinical records in the form of study models were taken at the start of active treatment (T1), at debond (T2), 6 months into the retention phase (T3), and 1 year post-debond (T4). The irregularity index, intercanine width, intermolar width, arch length, overbite, overjet, and Peer Assessment Rating (PAR) scores were measured on study models using digital callipers. A Mann-Whitney test was used to evaluate the treatment changes within each group. The only statistically significant difference was found to be at T3 and T4 for overbite (P = 0.05 and P = 0.02, respectively). PAR scoring showed more variable changes in group 2. There was good correlation for the measurement method. There was no statistical difference for the two groups for overjet, arch length, intermolar width, intercanine width, and irregularity index at any time point.

The literature pertaining to the extraction of third molars is extensive. There is a large individual variation and a multitude of practitioners' beliefs and biases relating to the extraction of especially asymptomatic and pathology free third molars. With the current emphasis in dentistry being placed on clinicians to make evidence-based decisions, the routine removal of third molars has been re-assessed and questioned. The purpose of this paper was to evaluate past and present knowledge of third molar extractions and relate it to logical considerations relevant to science and the evidence-based decision-making process. This paper endeavours to encourage and stimulate clinicians to re-evaluate their views on third molar extractions based on suggested guidelines and current evidence.

Objective: To compare the opinions of Swedish orthodontists and American orthodontists regarding the association between third molar eruption and dental crowding., Materials and Methods: A survey was distributed to Swedish orthodontists (n = 230) asking their views on the force exerted by erupting third molars, its relationship to crowding, and their recommendations for prophylactic removal. Results were compared with those from a similar study conducted in the United States. Chi square analysis was used to determine differences in responses to questions between Swedish and American orthodontists. P < or = .05 was considered significant., Results: Both Swedish and American orthodontists believed that lower third molars were more likely than upper third molars to cause force (65% and 58% for Swedish and American orthodontists, respectively) and crowding (42% and 40%, respectively). No statistically significant differences were seen between the answers of American and Swedish orthodontists regarding the role of upper and lower third molars in causing crowding. Although only 18% of Swedish orthodontists "generally" or "sometimes" recommended prophylactic removal of mandibular third molars, 36% of American orthodontists "generally" or "sometimes" recommended removal (P < .0001)., Conclusions: Most orthodontists in the United States and Sweden do believe that erupting lower third molars exert an anterior force; however, they also believe that these teeth "rarely" or "never" cause crowding of the dentition. The reason that more American orthodontists recommend prophylactic removal of mandibular third molars remains unexplained.

This study assessed the effect of extraction and preservation of the 1st premolar on lower 3rd molar eruption. Orthodontic clinic records from 1993 to 1995 were evaluated before and after treatment and 8-9 years after treatment for 3 groups of patients: 32 with extraction of 1st premolars in both jaws, 32 with no extraction but orthodontic treatment and 48 controls with no extraction but orthodontic treatment in the upper jaws only. Successful eruption of 3rd molars was evaluated. There was a significant difference in the rates of successful eruptions in the extraction (42%), non-extraction (12%) and control (20%) groups. The findings indicate that 1st premolar extraction may increase the chance of 3rd molar eruption, leading to a lower incidence of health and economic complications.

In the present context of the public health directions, considering WHO main objective, that "all people of the world could reach the highest possible health level", in medicine, the accent is put on prevention. In spite of the important progresses achieved in orthodontics field, the treatment still remains a symptomatic one. In this context, we must ask ourselves what are the prevention theoretical and practical coordinates in orthodontics, which measures are available or could be elaborated for preventing the malocclusions development. From the clinical point of view, the most important element of the new perspective is that most of the cases of anomalies which in the present are cured by orthodontics are induced by functional and environmental factors and they can theoretically be prevented. Thus, the identification, control and guidance of the environmental factors which adjust the growing of the maxillaries and of the other cranio-facial structures would be the main target of a prevention program in orthodontics.

Objective: To determine whether lower lingual, canine to canine, bonded multistrand retainers prevent relapse of lower labial segment alignment following fixed appliance therapy and to compare this with lower Hawley-type removable retainers., Materials and Methods: Two groups of 29 patients were identified. Group 1 had bonded lower canine to canine multistrand retainers placed following debonding, whereas Group 2 had lower Hawley-type retainers (with acrylic labial to the incisors) fitted following debonding. Study models were taken of all patients at debonding (T(1)) and at least 1 year post debonding (T(2)). Changes in Little's index over the study period were recorded using a reflex microscope., Results: Statistically significant changes in Little's index occurred in the lower labial segment of both study groups (P = .001) over the observation period. There was no statistically significant difference in the amount of change in Little's index between the bonded and removable retainer groups (P = .13). Bonded retainers tended to be placed in older patients (P = .02)., Conclusions: Relapse can occur in the lower labial segment with both fixed and removable retainers. The amount of relapse seen with both types of retainer is not statistically significantly different.

This study is a follow-up of one made in 1998-99 on first-year dental students in Monastir. Now in their fifth year, we assessed the effect of dental studies on students' oral health practices and dental health. Of the 155 students in the first study, 140 were still enrolled. Periodontal troubles, malocclusion and dental decay affected 84.3%, 80.0% and 43.0% of the students respectively. Compared with the previous study, students had achieved a better dental health status--tooth brushing rate was much higher, prevalence of dental decay and periodontal pockets had decreased, and DMF index had improved. However, the prevalence of smoking, bleeding and calculus had not changed, and the frequency of malocclusion had increased.

Lip bumper treatment has been shown to successfully increase arch width, procline the incisors, and distalize molars. However, few studies have been performed showing the long-term stability of lip bumper treatment. In this study, mandibular casts taken by a single practitioner from 51 patients treated with lip bumpers without rapid palatal expansion were analyzed at pretreatment, post-lip bumper treatment, posttreatment, and long-term out of treatment. Measurements of arch width, arch depth, arch length, and anterior crowding were made. During treatment, there was a mean decrease in irregularity of 3.73 mm, with a posttreatment increase of 0.76 mm, for a net decrease of 2.97 mm. Despite posttreatment decreases, significant gains in arch width were maintained for extended periods of time. The intercanine width had a net increase of 1.78 mm (19% relapse), first premolars 3.39 mm (26% relapse), second premolars 2.58 mm (34% relapse), and first molars 2.17 mm (20% relapse). Lip bumper treatment along with fixed appliances is an effective means to obtain long-term increases in arch width and decreases in the irregularity index.

Objective: Early recognition of developing malocclusions and the potential for uncomplicated orthodontic treatment procedures can minimize or eliminate future costly treatment. This study was designed to assess the potential for this approach in children living in a limited-income environment. A modified index for preventive and interceptive orthodontic needs (IPION) was used to determine the need for such treatment in schoolchildren aged 6 and 9 years., Methods: Two calibrated examiners examined each child independently and assessed several components of his or her occlusion, including molar relationship, crossbite, open bite, overbite and overjet. Dental variables such as presence of caries and early loss of teeth were also noted. Informed consent was obtained and all children present at school on the day of the field study were included. A total of 395 children were divided into 2 groups, aged 6 and 9 years., Results: A high prevalence of caries in the deciduous dentition (30.4% for 6 year olds; 20.6% for 9 year olds) and early loss of primary teeth (11.9% for 6 year olds; 29.4% for 9 year olds) was observed. A large percentage of children had crossbite in the anterior or posterior segments, or both. Open bites were also a common finding. Future orthodontic problems were identified in 28% of this population by using the modified IPION. No statistically significant differences (p > 0.05) were found between sexes or age groups using the chi2 test., Conclusions: Most of the developing malocclusions identified in this study would be amenable to interceptive orthodontics, consisting of space maintenance, crossbite correction and arch expansion.

Aim: To review the frequency of routine annual dental examinations for children in Finland and to make recommendations for appropriate examination intervals for children and adolescents., Method: The National Research and Development Centre for Welfare and Health in Finland appointed an expert group to prepare a review., Results: According to the literature, examination intervals for individuals with low caries risk can be extended to 1.5-2.0 years without jeopardising their oral health. If implemented, this would lead to a saving of 15% in treatment and examination times for children. Although there is no accurate measure for identifying high-risk individuals, a considerable proportion of low-risk children can be identified fairly accurately., Conclusions: The expert group recommended prolonging the average examination intervals to 1.5-2.0 years, taking into account the risk of each individual, the local distribution of oral health problems and cost-effective use of resources. Part of the savings could be redirected to children with high levels of dental need and/or at risk of dropping out from the oral health services.

Mandibular and maxillary third molars are mostly consigned to 'waste bins' in dental practices because they are terminal in developmental timing and positioning in the dental arches, and regarded as functionally non-essential. Thus, many dental practitioners do not attach significance to the presence of third molars when making therapeutic recommendations to patients about preservation of the dentition. The need for taking more a serious account of third molars is reviewed in this paper.