Predictors of treatment decisions made by adult orthodontic patients presenting with unerupted permanent teeth.

OBJECTIVE: Unerupted permanent teeth are amongst the most commonly occurring dental anomalies in adults and present unique treatment challenges. The aim of this retrospective study was to (1) identify the prevalence of adult patients with unerupted teeth attending a multidisciplinary clinic and (2) to identify predictors (age, gender, incisor and skeletal classification) which influence the patients treatment decision. MATERIAL AND METHODS: Consecutive adult patients with unerupted permanent teeth attending the Joint Orthodontic-Restorative clinic were identified. Study variables were collected using a prespecified data collection form. Descriptive statistics were employed; Fisher's exact test was used to detect associations between variables and treatment decision outcome. Ordinal logistic regression derived multinomial regression relative risk ratios (RRR) and 95% confidence intervals (CI) were calculated for the effect of age, gender, incisor and skeletal classification on treatment decision/outcome. RESULTS: Sixty-six patients with impacted teeth were identified from a sample of 483. The prevalence of adults with unerupted teeth was 13.7%. The mean age was 30.7 years (SD 11.2). The majority of the sample had a Class I incisor relationship (54.6%) or Class I skeletal base relationship (54.6%), and the most common distribution of impacted teeth was a single unerupted upper right canine (34.9%). Orthodontic treatment (non-extraction or extraction basis incorporating the alignment or removal of impacted teeth) and restorative treatment only were equally favoured. Factors including age, gender, incisor and skeletal classification did not appear to influence or predict the final treatment decision. CONCLUSIONS: In this sample, adults presenting with impacted teeth favoured certain treatment modalities: orthodontic treatment only and restorative treatment only. Factors such as age, gender, incisor and skeletal classification did not influence the outcome.

Factors influencing satisfaction with the process of orthodontic treatment in adult patients.

INTRODUCTION: Despite the increases in adults undergoing orthodontic treatment in both the public and private sectors, satisfaction with the treatment process has not been widely explored. In this study, we investigated factors influencing satisfaction with the process of orthodontic treatment in adult patients. METHODS: This was a prospective cross-sectional qualitative study. Participants were adults who had completed orthodontic treatment with fixed appliances and were recruited from 2 sites (a National Health Service public sector teaching hospital and a private specialist practice). Data were collected using in-depth interviews, and a content thematic analysis with a framework approach was used to analyze the data. RESULTS: A total of 26 adults were recruited (13 at each site). Five main themes were identified relating to patient satisfaction with the process of treatment: communication, staff, physical environment, appointments, and impact of appliance treatment. Effective communication was a dominant theme, particularly relating to explanations during treatment and making patients feel involved in their own care. CONCLUSIONS: In general, adult orthodontic patients were satisfied with the process of treatment, and good communication played a major part in this. Despite the differences in working models in the public and private sectors, many similarities arose when comparing the factors between the 2 sites.

The SECONDI MAPZ(©) system: a practical guide and proof of concept.

The SECONDI MAPZ(©) system is a new, simple, and logical classification of oncological defects of the midface that combines regional anatomy, 3-dimensional visualisation, and the hierarchy of functional priorities. In this paper, we provide clinical and radiographic examples of defects of varying complexity to illustrate the application of the system, to highlight its versatility, and to give practical clinical and radiological guidance on its use. We hope that its introduction will result in better communication of information, and the collection of more uniform data with which to compare outcomes, and ultimately will facilitate evidence-based practice in head and neck oncology.

The SECONDI MAPZ(©) system: new approach for the classification of oncological defects of the midface.

The appearance and function of the midface are crucial physiologically, psychologically, and aesthetically, and defects in the region can be devastating. Most of these defects are caused by operations for cancer, for which surgical access and rehabilitation can be challenging. Clinical evidence in midfacial ablative surgery is limited because differences between existing classifications do not allow a uniform approach to data recording, which makes comparison difficult. We explore the history of the classification of midfacial and maxillary defects, we analyse the shortcomings of those currently in use, and propose a new system that enables defects to be mapped simply, logically, and accurately.

Occult caries or pre-eruptive intracoronal resorption? A chance finding on a radiograph.

The purpose of this paper was to describe a rare case of idiopathic coronal resorption of an unerupted permanent mandibular second molar, which was detected as a chance finding on an orthopantomogram taken to assess dental eruption on a young patient about to start orthodontic treatment. The affected tooth was removed and underwent histopathological investigation. This case report provides a discussion of the possible etiologies for this radiographic appearance, as well as the diagnosis and management of such lesions. Failure to identify such lesions can potentiate a guarded prognosis. Further research is required in this field to investigate the etiology and pathological process, albeit this is limited by the rarity if these lesions.