Outcome of combined orthodontic-surgical treatment in a United Kingdom university dental institute.

INTRODUCTION: This retrospective observational cohort study evaluated effectiveness of combined orthodontic-orthognathic surgical treatment in a UK University Dental Institute. METHODS: Patients were identified from a database maintained prospectively throughout a 5-year period of observation. Demographic and clinical data included age, malocclusion, Index of Treatment Need, Index of Orthognathic Functional Treatment Need, orthodontist, surgeon, surgical procedure and treatment-time. Peer Assessment Rating (PAR) scores were generated from pre- and post-treatment dental study casts by a single calibrated examiner. RESULTS: One hundred and sixty two subjects began treatment during the period of observation, 92 completed, 14 elected to discontinue before surgery and 56 remained in treatment. Outcome data were available for 73, 16 males and 57 females (mean age 23.28 [SD, 7.92] years). Within this sample, 33 (45.2%) presented with class II division 1, 6 (8.2%) with class II division 2 and 34 (46.6%) with class III malocclusion. Isolated maxillary and mandibular surgery was carried out in 3 (4.1%) and 24 cases (32.8%), respectively; bimaxillary surgery was performed in 46 (63.1%). Mean total treatment time in fixed appliances was 920.28 days (30.7 months). Mean pre-treatment PAR score was 39.09 [SD, 9.42] and post-treatment 5.86 [SD, 4.25] with a mean 83.7% PAR score reduction, representing a greatly improved occlusal result. Kruskal-Wallis testing found no evidence of any relationship between independent variables and percentage PAR reduction; however, surgeon identity did significantly influence treatment length (P = 0.007). CONCLUSIONS: This investigation demonstrates that in terms of static occlusion combined orthodontic-orthognathic surgery is effective in correcting severe malocclusion.

Reporting quality of abstracts of randomized controlled trials published in dental specialty journals.

OBJECTIVES: A widespread assessment of the reporting of RCT abstracts published in dental journals is lacking. Our aim was to investigate the quality of reporting of abstracts published in leading dental specialty journals using, as a guide, the CONSORT for abstracts checklist. METHODS: Electronic and supplementary hand searching were undertaken to identify RCTs published in seven dental specialty journals. The quality of abstract reporting was evaluated using a modified checklist based on the CONSORT for abstracts checklist. Descriptive statistics followed by univariate and multivariate analyses were conducted. RESULTS: 228 RCT abstracts were identified. Reporting of interventions, objectives and conclusions within abstracts were adequate. Inadequately reported items included: title, participants, outcomes, random number generation, numbers randomized and effect size estimate. Randomization restrictions, allocation concealment, blinding, numbers analyzed, confidence intervals, intention-to-treat analysis, harms, registration and funding were rarely described. CONCLUSIONS: The mean overall reporting quality score was suboptimal at 62.5% (95% CI: 61.9, 63.0). Significantly better abstract reporting was noted in certain specialty journals and in multicenter trials.

Influence of supplemental written information on adolescent anxiety, motivation and compliance in early orthodontic treatment.

OBJECTIVES: To test the null hypotheses that supplementation of verbal information with written information when obtaining consent to orthodontic treatment has no effect on (1) anxiety, motivation and apprehension related to treatment and (2) compliance in the early stages of fixed appliance therapy. MATERIALS AND METHODS: Seventy-six adolescents who were due to start fixed appliance therapy were randomly allocated to receive verbal information only or verbal and written information before orthodontic treatment. Participants' anxiety, motivation, and apprehension were assessed using a questionnaire that was completed prior to meeting the orthodontic clinician (T1), following consent to treatment (T2), and after 12 weeks of treatment (T3). Appointment attendance, appliance breakages, and periodontal scores were used as measures of patient compliance. RESULTS: Sixty participants completed the study. At T2 there was no change in anxiety scores for either group (P = .412); however, increased motivation was detected in the group that had been given both written and verbal information (P = .049). At T3 both groups demonstrated similar reductions in anxiety (P = .311) and apprehension (P = .790) and similar levels of motivation (P = .756). A reduction in periodontal scores (P = .065), better appointment attendance (P = .732), and fewer breakages (P = .525) were reported in the group that was given additional information, although these changes were not statistically significant. CONCLUSIONS: Supplementation of verbal information with written information resulted in improved motivation for orthodontic treatment but had no statistically significant effect on anxiety, apprehension, or patient compliance.