Clear aligner therapy practice among orthodontists in the United Kingdom and the Republic of Ireland: A cross-sectional survey of the British Orthodontic Society membership

OBJECTIVE

To investigate clear aligner therapy (CAT) practice among orthodontists in the British Orthodontic Society (BOS).

DESIGN

A cross-sectional online survey.

METHODS

An electronic survey was distributed to members of the BOS in 2022. The survey comprised questions regarding respondent demographics, general use of CAT, the choice of proprietary CAT appliances, CAT planning, case selection, treatment protocols and orthodontist-reported CAT problems.

RESULTS

Overall, 233 (19.5%) responses were received with the majority (n = 121, 53.1%) being female. Most respondents reported practising in England (n = 171, 74.7%). The majority (n = 177, 77.3%) indicated that they used CAT in their practice, with 48.1% (n = 81) treating 1-20 patients with CAT annually. The most frequently prescribed CAT system was Invisalign (n = 138, 81.2%). One to three changes to the initial digital treatment plan were made by 72.9% (n = 121) with final tooth positions being the most common reason for adjustment (64.4%). Most (n = 97, 60.3%) rarely or never performed premolar extractions with CAT. Of the respondents, 23 12.7%) reported that they always or mostly used a remote monitoring system in conjunction with CAT, with a wide range of aligner change protocols reported. The median number of months required to complete non-extraction CAT reported by the respondents was 12. Most respondents (n = 77, 51.7%) did not feel that CAT provides superior outcomes compared with fixed appliance therapy.

CONCLUSION

CAT practice varied widely among the surveyed orthodontists. A predilection for the use of Invisalign and utility in less severe cases was noted.

Significance of Non-Statistically Significant Results in the Prediction of Oral Health-Related Quality of Life in Orthodontic Patients: A Survey Using Two Linking Questionnaires

Patients with a fixed orthodontic appliance may have difficulties in maintaining good oral health-related quality of life (OHRQoL), and evaluating self-perceived OHRQoL in orthodontic patients could be challenging for their orthodontists. Therefore, this research was conducted to investigate whether orthodontic postgraduates would accurately evaluate the OHRQoL of their patients. Two self-administered questionnaires were designed for patients to rate their OHRQoL and for their orthodontic postgraduates to evaluate them on OHRQoL. All pairs of patients and their orthodontic postgraduates were requested to independently complete the questionnaires. Pearson's correlation and multiple linear regression were performed to determine the relationships of the variables and to identify significant predictors on OHRQoL, respectively. There were 132 pairs of orthodontic patients and their residents who completed the questionnaires. There were no significant correlations between OHRQoL perceived by patients and evaluated by their orthodontic postgraduates in all aspects of treatment needs and dietary difficulties (p > 0.05). In addition, the regression model demonstrated no significant predictors for the self-perceived treatment needs and dietary difficulties of orthodontic patients. There seemed to be challenges for orthodontic postgraduates to evaluate their patients' oral health-related quality of life. Therefore, the OHRQoL measures should be increasingly implemented in orthodontic education and practice in order to enhance the concept of patient-centered care.

The Pandemic Impact of COVID 19 on Orthodontic Practice: A Cross Sectional Study

AIM

The objective of this study was to determine the problem encountered by an orthodontist due to suspended treatment during and after lockdown COVID 19 and to assess the pandemic impact on orthodontic practices.

MATERIALS AND METHODS

This was a cross-sectional web-based questionnaire survey conducted among orthodontist in India. The pilot study was conducted to estimate the sample size and final sample size is 263 participants. The predesigned and validated, self-administered, structured 10 questions related to the impact of an orthodontist and their orthodontic practices during and after COVID 19 are used. The statistical analysis was done using Statistical Package for Social Sciences SPSS (V 22.0) the frequency distribution was computed.

RESULTS

The result showed that 81% orthodontist were reported that routine orthodontic treatment was disturbed due to this COVID 19 lockdown, about 79.1% reported hospital/clinic was closed due to lockdown with a duration of more than 1 month. Still, 64.6% orthodontist handling their orthodontic emergencies through telecommunication and 47.9% of orthodontist received a complaint about fixed appliance among all other appliances. Due to the current situation, 41.4% orthodontist suggested 3-6 months' period required to normalize the current situation and 66.9% agreed that there will be decline in orthodontic treatment need after COVID 19.

CONCLUSION

Owing to the high virulence activity, elective procedures have been postponed and can manage a patient through virtual teleconsultation. Reassurance of the patient is needed regarding prolonged treatment duration due to this COVID 19 pandemic.

Coronavirus Disease 2019-Challenges Today and Tomorrow in Orthodontic Practice: A Review

From the start of 2020, the world has witnessed the biggest health and humanitarian crisis in the modern century named coronavirus disease 2019. The rapid spread of infection created chaos and confusion across the globe. Like all other health professions, a timely and major reorganization of orthodontic services is challenging. Unlike other medical emergencies, an orthodontic emergency does not require immediate attention in most cases. With advances in the modern web-based communication systems, minor problems can be managed online in orthodontic practice. During an emergency, however, orthodontists have a moral obligation to treat and manage patients under the World Health Organization guidelines and protocol.

The COVID-19 pandemic and orthodontic practice in Nigeria

OBJECTIVES

This study was aimed at assessing the knowledge and awareness of orthodontists and orthodontic residents in Nigeria about the COVID-19 pandemic and the appropriate infection control measures required to mitigate its spread in orthodontic practice.

MATERIALS AND METHODS

It was a cross-sectional descriptive study of orthodontists and orthodontic residents. Ethical approval for the study was obtained from the Institutional Review Board. Data collection was via an online questionnaire designed using Google forms and these were sent to the phone numbers of study participants. Data analysis was done using Statistical Package for Social Sciences version 20.

RESULTS

A total of 73 respondents with a mean age of 43.41 ± 9.21 years participated in the study. About 90% of the respondents had a very good knowledge of COVID-19, including its etiology, modes of transmission, signs, and symptoms. However, very few respondents were aware of the less common symptoms such as skin rash (16.4%) and red eyes (26%). Over 80% of the respondents knew the appropriate measures to take to prevent the spread of the virus in the dental clinic, in addition to the appropriate personal protective equipment (PPE) to use.

CONCLUSION

The respondents had a very good knowledge of the basic epidemiology of COVID-19 and the means of prevention of its transmission in the dental clinic. However, there was limited knowledge of the less common symptoms of the infection. In addition, majority of the respondents had a very good idea of the appropriate PPE to be used.

A proposed classification for orthodontic practice in India

Aim and Background:

Dental practice is blooming in India with many conventional and advanced setups providing orthodontic services. Orthodontics as a specialty has come to the forefront, as awareness of orthodontic therapy has increased. It is important to classify any health practice to understand, compare, and research the implications of various organizational setups in the country. It should possess the ability to chart the similarities and distinctions between different setups for ease of communication and patient awareness. Presently, there is no defined system that classifies the type of orthodontic practice in the country. Lack of any classification of the organizational setups makes it impossible to categorize or compare the various setups for research purpose, recognition of the dental personnel and facilities provided. This article aims to propose a simple 3-stage classification to orthodontic practices in India.

Technique:

Three-stage classification of orthodontic practice in group, type, and subtype gives a comprehensive coverage to all types of orthodontic setups in India. The group explains the center in three levels based on the armamentarium and services provided. The type explains the center in five levels based on ownership and scope of providing care. Finally, the subtype explains the availability and qualification of the operating personnel.

Conclusion and Significance:

This classification aims to provide a tool for communication and recording the levels of orthodontic care possible at any given center. It also facilitates continued study of its impact on practice efficacy and patient awareness.