Palatally displaced and impacted canines – What is taught during postgraduate orthodontics training in Europe?

Objectives: One of the most challenging orthodontic treatments is displaced and impacted canines palatally displaced canines (PDC/PIC). The aim of this study was, therefore, to assess what postgraduate students are taught about PDC and PIC during their postgraduate orthodontic training (POT) in Europe. Materials and Methods: A digital survey containing 22 questions was sent to 164 POT programs in 28 European countries. Questions were asked about which interceptive and surgical treatments are taught, the advantages of different surgical procedures, and what dressing materials and X-rays are used for PIC therapy planning. Reminders were sent 4 times. Results: About 43% (71 POT programs) responded. Extraction of deciduous canines (76%) was the most favored interceptive treatment. A closed technique with a gingival margin flap and a gold plated chain was the most commonly taught surgical technique (69%), even though both open and closed exposure of PICs were performed in 54 postgraduate programs. Coe-Pak™ with sutures was one of the preferred dressing materials in open exposure. Active treatment was started before the canine erupted, that is, spontaneous eruption of the tooth following open exposure was not awaited by 1/3 of the respondents and 1/3 left the question unanswered. Closed exposure was more often preferred than open exposure for post-surgical, periodontal, and esthetic reasons. The most common radiographs before surgery were panoramic and intraoral radiographs. Cone-beam computed tomography was taken by half of the respondents when resorption of adjacent teeth was suspected. Conclusion: Extraction of deciduous canines as an interceptive approach to PDC and closed exposure of PIC were taught in most of the POT programs.

Australian Orthodontists Utilization and Attitude Toward a Government Funded Cleft Scheme

Objectives: To (1) survey Australian orthodontists about their involvement with a government-funded scheme for patients with clefts, the Medicare Cleft Lip and Cleft Palate Scheme (MCLCPS) and (2) investigate their attitude toward treating patients with clefts and their training in this respect. Design: A 13-question online survey was distributed to members of the Australian Society of Orthodontists. The survey gathered information regarding respondent demographics, the number of MCLCPS-eligible patients seen in the past 12 months and usual billing practices. Results: A total of 96 complete responses were obtained. About 70% of respondents had treated MCLCPS-eligible patients in the past 12 months and 55% saw between 2 and 5 patients during this time. The likelihood of treating patients with clefts increased by a factor of 4.8 (95% CI: 1.2-18.9) if practicing outside of a capital city and 1.5 times for each decade increase in orthodontist’s age (95% CI: 1.0-2.2). The MCLCPS was utilized by 81% of orthodontists with 26% of these respondents accepting rebate only. Most orthodontists felt their university training could have better prepared them to treat patients with clefts. A minority of orthodontists felt that a rebate increase would make them more likely to treat these patients. Conclusions: Australian orthodontists who treat patients with clefts tend to be older and work outside of capital cities. The decision to treat these patients tends to not be financially motived. Specialty orthodontic training programs could improve the preparedness of their graduates to treat patients with clefts.

Skeletal changes produced by cervical and parietal headgears: a cephalometric evaluation

Introduction Extraoral strength is the most common strategy to correct Angle Class II malocclusion, restricting and redirecting the maxillary growth. Objective To evaluate the skeletal changes resulting from the use of headgear, with cervical and parietal anchorages, associated with a full fixed orthodontic appliance, in growing patients with Class II malocclusion (Angle) treated in the clinic of an orthodontic training center. Material and method The ages at the beginning and end of the treatment, anchorage type, and the values of some cephalometric variables were obtained from the clinical files. After applying the inclusion and exclusion criteria, 56 patient files were selected. Then, the sample was divided into two groups, according to the anchorage type: cervical (n=30) and parietal (n=26). The differences between the initial (T1) and final (T2) values of cephalometric measurements SNA, SNB, ANB, AO-BO, GoGn.SN and LHF (percentage of lower facial height to total facial height) were evaluated in both groups. Result Significant differences between T1 and T2 were found relative to SNB and ANB variables in both groups. The AO-BO variable presented a statistically significant difference only in the cervical group. The remaining variables did not show significant differences between T1 and T2. Conclusion The skeletal changes resulting from the use of cervical or parietal anchorage were very similar. There was a decrease in the sagittal discrepancy between the maxillary bones due to forward displacement of the mandible, without significant vertical changes.

What I wish I’d learned as an orthodontic trainee: an online survey of British Orthodontic Society members concerning postgraduate training experiences

Objective: To survey the opinion of recently qualified and established orthodontists on the perceived value of their training and to identify specific areas which which were considered to be deficient, adequately covered or focussed on excessively. Design: Descriptive cross-sectional survey Setting: Online electronic questionnaire. Participants: Members of the British Orthodontic Society (BOS). Methods: An electronic questionnaire was circulated to members of the BOS focusing on dental education history, and opinions concerning orthodontic teaching generally and specific clinical and non-clinical subjects. Information was also obtained in terms of possible need for improvement, modification or removal of teaching on focused academic and clinical aspects. Results: A total of 217 responses were received from 1080 emailed invitations resulting in a response rate of 20.1%. Respondents were generally satisfied with their training both in relation to theoretical, academic and practical aspects. However, training was regarded as deficient by some respondents in respect of temporary anchorage devices (38%), bonded retainers (6%), experience with lingual appliances (47%), removable aligners (44%), inter-proximal reduction (24%) and adult orthodontics (16%), working with therapists (32%), and NHS contracts (47%) and commissioning (47%). Conclusion: The overall satisfaction of BOS members with postgraduate orthodontic training is generally high, although both recently qualified and established practitioners emphasised the need for better exposure to training in specific practical aspects and practice management within the NHS.

Enabling Training in Orthodontics Through Mobile Augmented Reality

Orthodontic education, which currently emphasizes a didactic and apprenticeship approach, is facing numerous pedagogical challenges that affect knowledge delivery and instruction. This chapter discusses the challenges and limiting factors that affect orthodontic training and proposes the use of mobile augmented reality (MAR) to create a platform for effective learning, visualization, deliberate practice, effective feedback, and a personalized learning environment. MAR, with its visually enriched clinical simulations and ubiquitous learning, can effectively reduce cognitive dissonance and improve overall retention and skill gain by students. However, MAR has its limitations, as the technology is still new and limited evidence is available to back up the claims of knowledge and skill gain in the health professional's education. This chapter also provides future directions for exploring and enabling MAR so that it can become an efficient tool for learning and instruction across all faculties of education.

TRADITIONAL LECTURE

Introduction: Use of audiovisual aids is not new to improve dental teachingefficiency. Objective: To compare the effectiveness of traditional lecture versus video fororthodontic training of dental interns. Study design: Prospective, Randomized trial. Setting:Orthodontic Dental Section, Faisalabad Medical University. Period: 15.7.2017 to 5.2.2018.Materials & Methods: Two groups of 15 dental interns were selected randomly at OrthodonticDental Section, Faisalabad Medical University. One group was presented with traditional lecturewhile other group was shown a video. The learning objective of both was to train the dentalinterns to bond molar tubes onto extracted human lower first molars. Dental interns bondedmolar tubes and results were assessed by an experienced blinded orthodontist. Resultswere analyzed for accuracy of molar tube bonding. Results: Results showed that there wasinsignificant difference between the two groups for accuracy of molar tube bonding ontoextracted human lower first molars (P value=0.3401). Conclusion: Traditional lecture and videowere equally effective for orthodontic training of dental interns for bonding of molar tubes.