Scope of practice and supervision of orthodontic therapists in the United Kingdom: Part 1: a national cross-sectional survey of orthodontists.

OBJECTIVE: Since the introduction of orthodontic therapists (OTs), there has been little research on the scope of practice and the level of supervision they receive. This study investigates how OTs are being utilised and supervised, and how this compares with current recommendations. METHODS AND PARTICIPANTS: A postal cross-sectional survey was mailed to all UK General Dental Council (GDC) registered specialist orthodontists. RESULTS: A 59.7% response rate (747) was achieved. 52% of the respondents reported they worked with/employed an OT. The majority of orthodontists worked with an OT in primary care (67%) seeing predominantly NHS (56%) patients and performed a wide range of duties. Orthodontists reported a perceived increase in clinical output (74%) and time available for treatment planning (61%). The majority (85%) of orthodontists indicated they provide a written prescription for the OT. Forty-two per cent reported the prescription did not contain the required information as stipulated by the GDC. CONCLUSIONS: OTs are valued members of the orthodontic team, improving productivity and allowing orthodontists more time for treatment planning. The majority of orthodontists appeared to be working to the BOS and GDC recommendations, with greater awareness needed regarding the provision of a written treatment prescription.

A Predictable Alternative to a Smile in Six Months?

The aim of this article is to explore the use of Incognito™ Lite as an alternative to competitors advertising a 'Smile in Six Months' or rather short-term orthodontics for improving dental appearance through tooth movement. The focus is on the varied clinical use of this appliance system and its comparative advantages, disadvantages and placement techniques. Some alternatives are discussed and appraised. Two cases successfully treated with Incognito™ Lite are then presented. Clinical relevance: A reliable and predictable tool for aesthetic alignment of teeth, creating a broader range of treatment options for both the clinician and the patient.

An Overview of the Surgical Correction of Dentofacial Deformity.

The correction of severe dentofacial discrepancies involving a combination of orthodontic and surgical therapies (termed 'orthognathic treatment') is commonplace. There is an abundance of evidence within this field but it is often inconsistent. This article is an evidence-based overview of such treatments and is aimed at the general dental practitioner. It will cover: the timing of treatment; the indications and risks associated with different surgical osteotomies; the magnitude of surgical movements that can be achieved with these procedures; and the importance of mandibular autorotation when planning treatment. Orthognathic treatment is considered to be the gold standard for comprehensive correction of severe dentofacial discrepancies. It is undertaken by a multidisciplinary team of clinicians involving, but not exclusive to, consultants in orthodontics and oral and maxillofacial surgery in secondary and tertiary medical centres throughout the United Kingdom. Clinical relevance: It is imperative that general dental practitioners have a good understanding of orthognathic treatment in order to recognize when such treatments are indicated, to inform the patient of possible treatment modalities and to be able to discuss associated risks in order to make appropriate referrals. Since treatment timing and magnitude of surgical movements have a profound effect on stability of the treatment result, these must be carefully considered by all clinicians involved in patient care to minimize relapse potential.

Effectiveness of photographs of study models for IOTN scoring.

AIM: The aim'of the present study was to investigate whether the same orthodontic information can be obtained from study models or photographs of study models in order to assess the Index of Orthodontic Treatment Need (IOTN). The study also aimed to assess inter- and intra-examiner reliability in the assessment of orthodontic treatment need. SAMPLE: Thirty sets of start and finish study models, demonstrating a range of malocclusions, were non-randomly obtained from patients treated at the University of Manchester Dental Hospital. The start models demonstrated a range of malocclusions (according to The British Standard Institute Incisor Classification 1983) of varying complexity. METHOD: Six photographic views of each set of study models were taken against a dark background. Millimetric distances were determined by using dividers to measure photographic distances and actual distances in millimeters from a ruler embedded in the image. Four examiners assessed the study models and photographs of the models in a random order and the Aesthetic and Dental Health components of the IOTN were recorded. RESULTS: There were no statistically significant differences in the IOTN scores from photographs of study models compared with IOTN scoresrom study models of the same patient. CONCLUSION: The IOTN scores derived from photographs of study models are valid and reliable measures of malocclusion.

An alternative approach to debonding lingual brackets.

This clinical pearl describes a technique of debonding the lingual brackets with minimum discomfort to the patient. It also reduces the risk of swallowing or aspirating the brackets and decreases the risk of enamel damage.

The invisible Hawley retainer.

UNLABELLED: This paper provides an overview of orthodontic retention. A clinical case is presented using the aesthetic Clearbow® to retain a hypodontia case prior to restorative replacement of a developmentally absent upper right lateral incisor tooth (UR2). CLINICAL RELEVANCE: Orthodontic retention is an important part of treatment. This is especially so in the treatment of multi-disciplinary hypodontia cases. The Clearbow®, aesthetic labial bow provides superior aesthetics in comparison to conventional Hawley retainers.

Invisible orthodontics part 3: aesthetic orthodontic brackets.

UNLABELLED: In this, the third part of the series, aesthetic orthodontic treatment will be considered. The previous two articles have looked at invisible orthodontics with Invisalign and lingual brackets. This article will discuss the properties and use of aesthetic brackets, along with examples of orthodontic treatment cases using the aesthetic brackets. CLINICAL RELEVANCE: Increasing demand for aesthetics during orthodontic treatment has resulted in a significant increase in the use of aesthetic brackets. Clinicians need to be aware of the benefits and drawbacks of aesthetic brackets.

Invisible orthodontics part 1: invisalign.

UNLABELLED: This paper discusses the invisible orthodontic treatment modalities of Invisalign aligners, lingual appliances and aesthetic brackets. The first part of this three-part series will discuss Invisalign aligner treatment. The second part will discuss lingual appliance treatment and the third part will focus on aesthetic brackets. The benefits and drawbacks of Invisalign treatment are considered in detail, including examples of treated cases and a review of the literature to date. CLINICAL RELEVANCE: Patients are increasingly requesting more aesthetic forms of orthodontic treatment. Clinicians need to be aware of the indications and limitations of such invisible therapies so that they can fully inform their patients.