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Abstract Background Due to the limited evidence of the cost-effectiveness of Community Health Workers (CHW) delivering treatment for severe acute malnutrition (SAM), there is a need to better understand the costs incurred by both implementing institutions and beneficiary households. This study assessed the costs and cost-effectiveness of treatment for cases of SAM without complications delivered by government-employed Lady Health Workers (LHWs) and complemented with non-governmental organisation (NGO) delivered outpatient facility-based care compared with NGO delivered outpatient facility-based care only alongside a two-arm randomised controlled trial conducted in Sindh Province, Pakistan. Methods An activity-based cost model was used, employing a societal perspective to include costs incurred by beneficiaries and the wider community. Costs were estimated through accounting records, interviews and informal group discussions. Cost-effectiveness was assessed for each arm relative to no intervention, and incrementally between the two interventions, providing information on both absolute and relative costs and effects. Results The cost per child recovered in outpatient facility-based care was similar to LHW-delivered care, at 363 USD and 382 USD respectively. An additional 146 USD was spent per additional child recovered by outpatient facilities compared to LHWs. Results of sensitivity analyses indicated considerable uncertainty in which strategy was most cost-effective due to small differences in cost and recovery rates between arms. The cost to the beneficiary household of outpatient facility-based care was double that of LHW-delivered care. Conclusions Outpatient facility-based care was found to be slightly more cost-effective compared to LHW-delivered care, despite the potential for cost-effectiveness of CHWs managing SAM being demonstrated in other settings. The similarity of cost-effectiveness outcomes between the two models resulted in uncertainty as to which strategy was the most cost-effective. Similarity of costs and effectiveness between models suggests that whether it is appropriate to engage LHWs in substituting or complementing outpatient facilities may depend on population needs, including coverage and accessibility of existing services, rather than be purely a consideration of cost. Future research should assess the cost-effectiveness of LHW-delivered care when delivered solely by the government. Trial registration NCT03043352, ClinicalTrials.gov. Retrospectively registered.

The prime objectives of this study were to compare stability in incisor irregularity, intercanine width, interpremolar width, intermolar width, arch length, and arch depth after debonding and at six months of retention via laser scanned digital dental models (LSD) and digital calliper (DC). This study was designed and conducted according to the Consolidated Standards of Reporting Trials (CONSORT) guidelines. The selected 47 orthodontic patients (age = 21.58 ± 2.94 years) were randomized into two groups to receive either a passive self-ligating (Damon® 3MX 0.022-in slot, n = 23) or a conventional system (Gemini MBT 0.022-in slot, n = 24). Dental models of each subject for maxillary arch were scanned via NextEngine laser scanner and ScanStudio HD software. The maxillary arch variables assessed via Laser scanned digital dental models (LSD) and Digital Calliper (DC) were measured. The ICC coefficient values for inter-examiner were all in the range of strong correlation. Differences between the laser scanning and digital callipers measurements in most parameters were small except for the upper arch length at baseline and, none were statistically different. The stability for maxillary incisor irregularity, intercanine width, interpremolar width, intermolar width, arch length, and arch depth after debonding and at six months of retention via laser scanned digital dental models (LSD) and digital calliper (DC) revealed no significant difference. Thus for orthodontic treatment stability assessment both digital calliper and 3D dental models can be used. [ABSTRACT FROM AUTHOR]

Maxillary lateral incisors are only second to third molars, when it comes to variation in the form or morphology. Since the upper lateral incisors play an important role in the appearance of smile, any abnormality in their appearance or their complete absence, always attracts a great deal of attention. The prime objective of this study was to determine the prevalence of peg shaped and missing permanent maxillary lateral incisors in a Pakistani population. The total sample size for this study comprised of 650 patients (N = 650) belonging to both genders (Males: 350; Females: 300) and the age range of the participants was 18-25 years. The routine pre-orthodontic records were obtained. The intra oral clinical and radiographic examination was performed for peg and missing maxillary lateral incisors. Data were collected and analyzed statistically using chi-square test. The male participants had greater percentage of missing maxillary lateral incisors as compared to the females, but the difference was not statistically significant (p-value = 0.398). Females had greater prevalence of peg lateral incisors as compared to their male counterparts, but the difference was not statistically significant (p-value = 0.274). Maxillary lateral incisors are one of the forward-facing important tooth to achieve the pleasant smile and ideal occlusion. The peg shaped and missing maxillary lateral incisors leads to tooth size discrepancies, therefore they must be considered in orthodontic diagnosis and treatment planning. [ABSTRACT FROM AUTHOR]

The purpose of this study was to investigate the maxillary arch bone density, arch dimensional changes and little irregularity index at completion of levelling and alignment stage of orthodontic treatment and to assess the influence on bone density instance to orthodontic treatment progression. This pilot study consisted of 5 patients with Class II division 1 malocclusion treated with extraction of two maxillary first premolars. The data source was CBCT high volumetric data. All measurements were obtained through CBCT Planmeca Romexis TM Software 2.3.1.R (Helsinki, Finland). Variables recorded for each patient included gender, age, bone density at apical, middle and cervical region of maxillary anterior teeth, inter canine width (ICW), inter second premolar width (IPMW2), inter first molar width (IMW1), inter second molar (IMW2), arch length (AL), arch depth (AD) and little irregularity index (LII). The non-parametric Wilcoxon rank test were used for statistical analysis. Generalized reduction was observed with significant difference (P<0.05) for bone density mostly at the apical region upon completion of levelling and alignment stage. Bone density in the apical region of central incisors and cervical region of canine were significantly different between left and right sides (P<0.05). IPMW2 was increased and the LLI was decreased with significant difference (p<0.05) after levelling and alignment stage of orthodontic treatment. Generalized reduction in bone density were observed at the completion of maxillary arch levelling and alignment stage of orthodontic treatment especially in the apical region of central incisors and canine. The progress of orthodontic treatment has a positive impact on the arch dimensions and little irregularity index. [ABSTRACT FROM AUTHOR]

Tooth loss can be a major cause of functional, psychological and social discomfort. These factors lead to an increase in concerns about oral and dental health. The basic aim of this study was to assess association between tooth loss and oral awareness amongst dentate and partially dentate subjects. A cross-sectional study was carried out on 300 subjects divided into two equal groups i.e. dentate and partially dentate. Both the groups were assessed using the same questionnaire which was designed to acquire data of oral hygiene knowledge, attitude and practices in patients visiting the out-patient and prosthodontics department of FMH dental hospital. With regards to the knowledge about oral hygiene, 78.7% subjects in GROUP A considered plaque as a caries causing agent whereas in group B, 80% said yes to plaque being the caries causing agent. 88.7% in GROUP A and 84.7% in GROUP B believed that bleeding gums mean inflamed gingiva. According to 96% of group A subjects, cleaning of teeth in very important as opposed to the 4% that believed that it is not so important likewise 94% of group B subjects considered cleaning of teeth as very important. When asked about concerns regarding dental health, in group A 57.3% were very concerned, 42% were not so concerned and 0.7% had never bothered at all. In group B, 53.3% were very concerned, 41.3 were not so concerned and 5.3 % had never bothered about their dental health. In group A, Brushing frequency was reported as twice daily by 55.3 %, once daily by 35.3%, more than twice daily by 4% and 5.3% of patients brushed occasionally whereas in group B, 46% brushed twice daily, 40% once daily, 6% more than twice daily and 8 % brushed only occasionally. Group A subjects visited a dentist more frequently as compared to group B subjects. No significant difference in awareness regarding oral hygiene knowledge, attitude and practices was seen in the two groups. Intensive population-directed strategies for oral health education should be considered in order to further improve the oral hygiene practices of the entire population. [ABSTRACT FROM AUTHOR]

Objective: Functional appliances play an important role in achieving an ideal facial profile. Forsus has been assessed by orthodontists extensively to notice significant improvements in dental and skeletal growth pattern. It can control overbite, modify dental eruption and result in a good soft tissue profile of face. The prime objective of our investigation is to update the forsus fatigue resistant device fixed functional appliances. Material and methods: Online publication search engines were extensively searched using keyword combinations. Forest plot were analyzed for statistical analysis. Results: Forsus produces statistically significant changes in antero-posterior relationship of dental arches and can be used as a fixed functional appliance during fixed orthodontic treatment. Conclusions: Forsus is an effective mechanism for Class II correction, especially in patients with retrognathic chins and small mandibles. [ABSTRACT FROM AUTHOR]

Objectives: The craniofacial characteristics of Bangladeshi adults with class III malocclusion were investigated in order to formulate cephalometric angular and linear measurements and to compare their mean differences with the established values of class I Bangladeshi adults cephalometric norms. Materials and Methods: Fifty (50) standardized lateral cephalometric radiographs of Bangladeshi adults including 25 males and 25 females with an average age of 20 years were studied. The criteria of selection were Class III incisor relationship with or without crowding, no deformity, and no previous orthodontic treatment. All cephalometric landmarks were located and determined and subsequently tracings were done to perform cephalometric analysis. Results: The results of the present study showed no statistically significant difference between the genders on all measured values. Bangladeshi male showed larger values than those of the Bangladeshi females in most of the variables. Mean values of cephalometric norms of Bangladeshi adults were very much different than the Class III malocclusion adults. Conclusion: With this study during the treatment of Class III malocclusion, the reading should be kept in consideration for this group separately as it varies from the class I malocclusion. [ABSTRACT FROM AUTHOR]

Objective: The main objective of this innovation is to introduce a modification in fixed functional appliance installation technique to achieve mandibular advancement, overjet reduction in skeletal class II growing patients without much proclination of lower incisors. Methods: A growing female patient with skeletal class II relationship was treated with modified forsus appliance and checked for its effect on correction of class II relationship and lower incisor proclination. Results: This modification was proved to be successful in treating skeletal class II growing patients as a method to achieve mandibular advancement, maxillary incisors incisors retraction and overjet reduction with minimal effect on lower incisor proclination. Pre and post cephalometric analysis showed only 1° increase in lower incisor proclination. Conclusion: This method can be used in orthodontic practice in class II growing patients during first phase of orthodontic treatment with fixed functional appliance to achieve mandibular advancement and overjet reduction with more effective control over lower incisor proclination. [ABSTRACT FROM AUTHOR]

Objective: The prime aim of this clinical tip is to present the Management of Mallet finger injury via Alam prosthetic device (APD). Also with aimed to design such a type of the device: which is cost effective, affordable, thin, light, comfortable, smart, durable and improvised version amongst the splints that is available in the market. Method: APD is a custom-made splint was fabricated fast and easy on the finger working model. The fabrications tools were Dental impression putty (Hydrophilic Vinyl Polysiloxane), Gypsum product (hard plaster), Wax knife, carver and indelible pencil, cold cure acrylic. Results: APD was fabricated for the management of mallet finger injury. APD designed as thin, light, comfortable, smart and durable. Conclusion: Prognosis of mallet finger injury may vary. APD is one of the innovation can be consider a precious tool for the treatment of mallet finger injury in prospect. [ABSTRACT FROM AUTHOR]

Introduction: In circumstances where the ante mortem list is unknown, gender determination would exclude onehalf of the population, aid in a more precise search of the ante mortem records. This study aims to formulate gender prediction models in the Pakhtun Pakistani population using digital dental arch dimensions. Methods: Data collection and analysis of the dental casts were conducted on 128 subjects, 64 males and 64 females from the Pakistani population. The mean age of the subjects was 19.2 years old. Several linear dental arch dimensions were measured and recorded for both upper and lower arches. Results: It was found that gender differences in linear arch dimensions were statistically significant for both males and females (p<0.05); in which the arch dimensions for the males were larger than the arch dimensions for the females. Stepwise discriminant function analysis found that the highest discriminant power of the variables was present within the inter-second premolar width for the upper arch and inter-molar width for the lower arch. These variables significantly contributed to gender variance. Moreover, the prediction of 67.2% of original grouped cases for the upper arch and 66.4% of cross-validated group cases was correct. Similarly, the correct prediction was made on 64.8% of original grouped cases for the lower arch and 64.1% of cross-validated group cases. Conclusion: The dental arch dimensions were larger among the males compared to the females. Prediction models obtained in this study were moderately strong predictors which may be used as an adjunct to predict gender. [ABSTRACT FROM AUTHOR]

Background: The aim of the present study was to do an overview of the arch dimension for various populations. Also, to evaluate the various type of measurement methods and sexual disparities. Two reviewers independently performed the selection process and the quality of studies was assessed. Method: Studies published form January 2000 until October 2015 were identified in electronic databases: Pubmed, Scopus, Science direct, Web of Science, Medpilot and Medline using keywords. Criteria used included: observational studies, Arch size measured, Permanent dentition, Arch dimension investigated via plaster and digital dental models, measurement via calipers and computers software's. Result: The forest plots showed the continuous trend for the greater arch dimension for male in relation to female. The current overview showed the arch dimension and its disparities for various populations. Conclusion: The various methods to assess arch dimension should be carefully considered and well conducted as part of the clinical assessment of orthodontic treatment, since arch dimension could influence the diagnosis and treatment planning of orthodontist. [ABSTRACT FROM AUTHOR]

Introduction: In circumstances where the ante mortem list is unknown, gender determination would exclude onehalf of the population, aid in a more precise search of the ante mortem records. This study aims to formulate gender prediction models in the Pakhtun Pakistani population using digital dental arch dimensions. Methods: Data collection and analysis of the dental casts were conducted on 128 subjects, 64 males and 64 females from the Pakistani population. The mean age of the subjects was 19.2 years old. Several linear dental arch dimensions were measured and recorded for both upper and lower arches. Results: It was found that gender differences in linear arch dimensions were statistically significant for both males and females (p<0.05); in which the arch dimensions for the males were larger than the arch dimensions for the females. Stepwise discriminant function analysis found that the highest discriminant power of the variables was present within the inter-second premolar width for the upper arch and inter-molar width for the lower arch. These variables significantly contributed to gender variance. Moreover, the prediction of 67.2% of original grouped cases for the upper arch and 66.4% of cross-validated group cases was correct. Similarly, the correct prediction was made on 64.8% of original grouped cases for the lower arch and 64.1% of cross-validated group cases. Conclusion: The dental arch dimensions were larger among the males compared to the females. Prediction models obtained in this study were moderately strong predictors which may be used as an adjunct to predict gender. [ABSTRACT FROM AUTHOR]