Outcome of a scheme for specialist orthodontic care, a follow-up study in 31-year-olds.

Changes in the occlusion after orthodontic treatment have in several studies been analyzed by the use of the PAR Index developed by Shaw & Richmond. The use of the PAR Index has been shown by O'Brien & Shaw to be a reliable and reproducible method to evaluate orthodontic treatment results. The purpose of the study was to examine the long-range orthodontic treatment outcome by following a group of patients into adulthood to the age of 31 years. For the study 115 individuals from a previous randomized study were invited for follow-up examination at age 31 years. Seventy-two individuals, 32 males (44.4%) and 40 females (55.6%) of the original sample attended for clinical examination. Study casts were obtained and questionnaires addressing the patient's awareness and opinion of the treatment were distributed. In addition twenty-four subjects responded by returning filled-in questionnaires. The mean change in wPAR scores from start to retention represents a mean relative improvement in occlusion of 78.7%. The mean wPar score improvement from age 19 to 31 years was 11.9%. The relative mean wPar score change dropped to 53.5% at age 31 years. The differences in wPAR recordings between the recorded stages were all statistically significant. The treatment outcome as expressed by mean wPAR scores at age 31 years was significantly better among individuals treated with extractions compared to those treated without extractions. The mean wPAR scores of the individuals with retainers at age 31 years were significantly lower when compared to the mean score for those without retainers (unpaired t-test, p = 0.020). This clearly indicates the benefit of long-term retention. The changes in the concern scores from 19 to 31 years of age were small. At age 31 years only 8 of the 96 respondents (8.3%) expressed concern about the treatment outcome.

Effect of topical applications of a chlorhexidine/thymol-containing varnish on fissure caries assessed by laser fluorescence.

The aim of this study was to monitor the effect of an antibacterial varnish using the readings of a caries-detecting device (DIAGNOdent) in fissures of young permanent molars. The material consisted of 32 healthy patients with a mean age of 14.1 years undergoing orthodontic treatment with fixed appliances. The inclusion criteria were presence of one homologous pair of 2nd upper or lower molars with clinically intact occlusal surfaces. A split-mouth study design was used in which the fissures were treated with either an antibacterial chlorhexidine/thymol-containing varnish or a placebo varnish every 6th week. The follow-up period was 42 weeks and laser fluorescence (LF) readings were carried out every 12th week. The mean LF values increased significantly (P < 0.05) after 24, 36, and 48 weeks compared to baseline following the placebo treatments but not after treatment with the active antibacterial varnish. During the study period, micro-cavities were diagnosed in two test-treated and five placebo-treated teeth. In conclusion, the results reinforce previous findings that frequent applications of a chlorhexidine/thymol-containing dental varnish might have a protective role in fissures of young permanent molars and that this could be monitored with a chair-side caries detecting LF device.

Effect of a hydrophobic tooth coating on gingival health, mutans streptococci, and enamel demineralization in adolescents with fixed orthodontic appliances.

The effect of an anti-adhesive enamel coating on plaque accumulation, gingival health, and enamel demineralization was evaluated in 39 adolescents undergoing treatment with fixed orthodontic appliances using a prospective split-mouth design. Immediately after bracket insertion, the polymer was randomly applied after enamel etching to the buccal surfaces of the teeth in the left or right upper quadrant, leaving the opposite quadrant as an untreated control (218 test and 216 control teeth). Reapplications were carried out every 3rd month during the course or the study. The following data were collected at baseline and at designated follow-ups: visible plaque index, total viable counts and proportion of mutans streptococci in plaque samples, gingival bleeding index, and amount of gingival crevicular fluid. The incidence of enamel demineralization adjacent to the appliances was scored clinically at the termination of the orthodontic treatment. The observation time ranged from 6-24 months, during which the participants used fluoride rinses and toothpaste daily. A slightly impaired gingival health and increased levels or mutans streptococci compared with baseline was disclosed during the treatment. Five subjects showed enamel demineralization on a total of 30 teeth at the time of de-bonding. The results indicated no statistically significant differences between the enamel-coated and untreated teeth with regard to the studied variables at any follow-up. In conclusion, the present findings did not support a clinically beneficial effect of the polymeric tooth coating in a low-caries group of adolescents treated with fixed orthodontic appliances.