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.

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 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.

The Manchester positioner--dual retention made easy.

Accurate easy placement bonded retainers have long been a desired aspect of contemporary orthodontic treatment. This article offers the reader a simple and precise method of placing a fixed bonded retainer. This technique also has the advantage of providing a retainer that can be used as both the positioner and the dual removable retainer.

Reply letters following orthodontic consultations: an audit of Merseyside general dental practitioners' satisfaction.

OBJECTIVES: To assess the opinions of general dental practitioners (GDPs) working within the National Health Ser vice (NHS) in Merseyside regarding the length, format and appropriateness of consultant orthodontists' letters sent in reply to referral letters. MAIN OUTCOME MEASURES: These were GDPs' satisfaction with the length, format and content of the reply letters; GDPs' preferences for the information deemed necessary in such letters; GDPs' awareness of the status of their patients and the actions they were requested to undertake. METHOD: After piloting, questionnaires were mailed to 330 participating GDPs between August and October 2004. RESULTS: Two hundred and fifty-one (76%) questionnaires were returned. With one exception, the length of consultants' letters was thought to be adequate. Of the responding GDPs 82% stated a preference for summaries of the diagnosis and treatment plan to be presented in a list format rather than as free text. Aspects of the treatment plan were thought to be more important than the information about the examination. Following receipt of the reply letter only 71% of GDPs were aware of what was happening to their patients and 75% knew what actions they were to undertake. CONCLUSIONS: This audit provides evidence that GDPs consider that a significant portion of the information in consultants' reply letters is not needed. Relevant information may be poorly communicated.

Mandibular arch changes following nonextraction treatment.

OBJECTIVE: To evaluate mandibular tooth position changes following treatment with a lip bumper and fixed appliance. Specifically, we aimed to determine how space was obtained to align crowded lower incisors. METHODS: Thirty-four consecutively treated children with a mean age of 10.6 years (SD: 1.14 years) were selected from a specialist orthodontic practice in Eire. All subjects were treated with a lip bumper followed by a fixed appliance. The positions and angulations of the lower first molars and most proclined lower incisor were measured on the pretreatment and post-treatment lateral cephalometric radiographs and study models with a reflex metrograph. The changes were also compared with published growth data. RESULTS: After lip bumper and fixed appliance treatment the mandibular arch depth decreased (Mean difference: 1.2 mm; p < 0.01) and the mandibular intermolar width increased (Mean difference: 1.73mm; p < 0.01). The mandibular molars moved mesially (Mean difference: 2.14 mm; p < 0.01 and tipped distally (Mean difference: 4.36 degrees; p < 0.01). There were no significant differences between the pre- and post-treatment positions or angulations of the mandibular incisors. Compared to published growth data the arch depth decreased less, the intermolar width increased more and the mandibular molars were uprighted. There was no difference in the positions of the mandibular incisors in the treated group compared with published growth data. CONCLUSIONS: The main effects of nonextraction treatment with a lip bumper followed by fixed appliance treatment were to maintain the leeway space, expand the mandibular arch and 'upright' the lower molars. The treatment had no effect on the position of the lower incisors.