Smile aesthetics and malocclusion in UK teenage magazines assessed using the Index of Orthodontic Treatment Need (IOTN).
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OBJECTIVE: There is a significant demand for orthodontic treatment within the UK from adolescent girls, a group known to be influenced by the media portrayal of body form and body image, which may extend to the presentation of malocclusions. This study examined the portrayal of malocclusion in a media type that targets teenage girls under 16 years of age. MATERIALS AND METHODS: A representative selection of 1 month's magazines targeting this group were investigated, and the frequency and severity of malocclusions displayed were assessed. Two calibrated examiners viewed all the smiles (on two occasions) using a modification of Index of Orthodontic Treatment Need (IOTN) and assigned an Aesthetic Component Score to each smile. RESULTS: It was found that the aesthetic score is low (less than 7) for the majority of models (92.8%) indicating no need or a borderline need for treatment. Only 7.2% of models exhibited a definite need for treatment. CONCLUSION: It appears that the portrayal of malocclusion in teenage magazines does not reflect the general treatment need of the adolescent population. (+info)
Esthetic dentistry in North American dental schools.
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OBJECTIVES: Esthetic dentistry is among the most dynamic areas of contemporary clinical dentistry. Teaching programs in dental schools have a strong effect on the practice of dentistry, not only for recent graduates, but also for established clinicians, especially with respect to new techniques and concepts. The purpose of the study reported here was to assess the frequency and extent of the teaching of esthetic dentistry in North American dental schools and to report how it differs among the various schools. MATERIALS AND METHODS: A 19-question survey was mailed to 64 North American dental schools. The questions inquired about the priority given to the teaching of esthetic dentistry in the school; how the subject was taught (through regular curricular courses; through a multidisciplinary approach or through elective classes); the duration of the esthetic dentistry course; the nature of the course content (theoretical or practical); the esthetic procedures taught to undergraduate students; the level of interaction among different disciplines in the teaching of esthetic dentistry; and the techniques and commercial materials used. The responses were summarized as percentages based on the number of schools that responded to each question. RESULTS: Fifty-two (81%) of the 64 dental schools completed and returned the questionnaire. Twenty-five of these schools (48%; designated group A) reported having a course exclusively for the teaching of esthetic dentistry. Twenty-seven schools (52%; designated group B) reported that esthetic dentistry was addressed in multiple courses, i.e., no specific course was available. Four schools in group B (15%) were in the process of developing a separate course for esthetic dentistry. In group A schools, esthetic dentistry was taught mainly in the operative dentistry department or division. The most frequent course duration was 4 to 6 months, but there were marked variations. Thirteen (52%) of these 25 schools had didactic and practical teaching at both the preclinical and the clinical levels. The schools in group B reported that only clinical instruction in esthetic dentistry was provided. Several concerns were addressed in the courses offered in group A schools: extrinsic and intrinsic discoloration, bleaching, diastemas, malformation and malpositioning (the latter including rotation, intrusion and labio-linguoversion), and replacement of amalgam and gold restorations. Only 7 (28%) of the group A schools reported having the support of an inhouse laboratory. The esthetic procedures taught were similar for schools in group A and group B. The use of direct posterior composite restorations, all-ceramic crowns and nonvital bleaching was more common among group B schools. Ceramic inlays, onlays and indirect posterior composite restorations were not taught by 4 (16%) of the schools in group A and 7 (26%) of the schools in group B. CONCLUSIONS: The teaching of esthetic dentistry in North American dental schools is highly variable and in many schools is shared among different disciplines. Dental schools should work together to establish the parameters for teaching this subject and should formulate the necessary standards for education and research in this new field. (+info)
A comparison of current prediction imaging programs.
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To investigate perceived differences in the ability of current software to simulate the actual outcome of orthognathic surgery, we chose 10 difficult test cases with vertical discrepancies and "retreated" them using the actual surgical changes. Five programs--Dentofacial Planner Plus, Dolphin Imaging, Orthoplan, Quick Ceph Image, and Vistadent--were evaluated, by using both the default result and a refined result created with each program's enhancement tools. Three panels (orthodontists, oral-maxillofacial surgeons, and laypersons) judged the default images and the retouched simulations by ranking the simulations in side-by-side comparisons and by rating each simulation relative to the actual outcome on a 6-point scale. For the default and retouched images, Dentofacial Planner Plus was judged the best default simulation 79% and 59% of the time, respectively, and its default images received the best (lowest) mean score (2.46) on the 6-point scale. It also scored best (2.26) when the retouched images were compared, but the scores for Dolphin Imaging (2.83) and Quick Ceph (3.03) improved. Retouching had little impact on the scores for the other programs. Although the results show differences in simulation ability, selecting a software package depends on many factors. Performance and ease of use, cost, compatibility, and other features such as image and practice management tools are all important considerations. Users concerned with operating system compatibility and practice management integration might want to consider Dolphin Imaging and Quick Ceph, the programs comprising the second tier. (+info)
The relationship between patient, parent and clinician perceived need and normative orthodontic treatment need.
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The aim of the present study was to compare patient, parent and clinician perceived need for orthodontic treatment in relation to normative orthodontic treatment need as measured by the Index of Orthodontic Treatment Need (IOTN). A prospective cross-sectional study was designed to address this aim. The sample comprised 103 patients attending the 'new' patient clinic at the Jordan University Hospital. The patients' mean age was 15.3 years (standard deviation 3.8 years); 33 per cent were males and 67 per cent females. One clinician scored the patients' normative orthodontic treatment need using the IOTN, then determined perceived need using a 10 cm visual analogue scale (VAS). The subjects then assessed their own perceived need and aesthetic component (AC) score and the parents carried out similar assessments for their children. All scoring was carried out blind. The parents had the highest average perceived need scores, followed by patient and clinician scores (6.6, 6.1 and 5.4 cm, respectively). A significant difference was found between the parents and the clinician (P < 0.05). When the relationship between perceived need and clinician-measured normative orthodontic treatment need was investigated, significant differences were found with the dental health component (DHC) for all three groups (P < 0.05). Differences between AC and perceived need scores were also significant for the patients and parents, but not for the clinician (P > 0.05). The present study has shown that perceptions of orthodontic treatment need are multifactorial and influenced by elements other than health measures of normative orthodontic treatment need and perceptions of aesthetics. (+info)
Dentoskeletal effects and facial profile changes during activator therapy.
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The aim of this retrospective study was to investigate cephalometrically the skeletal, dental, and soft tissue modifications induced by activator treatment in patients with Class II malocclusions caused by mandibular retrognathism. The subjects, all in the mixed dentition, were selected from a single centre and were divided into two groups: 40 patients treated with an incisor double capping activator (20 girls, 20 boys with a mean age of 10 years) and a control group of 30 subjects (15 girls, 15 boys with a mean age of 10 years). The dentoskeletal and aesthetic changes that occurred were compared on lateral cephalograms taken before treatment (T0) and after 18-24 months, when the activator was removed (T1). In the control group the radiographs were obtained before (T0) and after (T1) 21 months (standard deviation +/- 3 months). Activator treatment in these growing patients resulted in a correction of the Class II relationship (ANB -2.14 degrees), a restriction of maxillary growth (SNA -0.5 degrees), an advancement of the mandibular structures (SNB +1.64 degrees, FH--NPg +3.39 degrees; OLp-B +5.17 mm, OLp-Pg +5.14 mm, OLp-Go +2.44 mm), a correction of the overjet (-5.03 mm), an improvement in overbite (-1.17 mm) and uprighting of the maxillary incisors (1--FH -5.64 degrees). The activator appliance was effective in treating growing patients with mandibular deficiency: activator therapy corrected Class II malocclusions by a combination of skeletal and dental changes and improved the soft tissue facial profile. (+info)
Lay person's perception of smile aesthetics in dental and facial views.
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OBJECTIVE: To compare the aesthetic perception of different anterior visible occlusions in different facial and dental views (frontal view, lower facial third view and dental view) by lay persons. DESIGN: Cross-sectional survey, Lima, Peru, 2002. SUBJECTS: The different views were rated by 91 randomly selected adult lay persons. MAIN OUTCOME MEASUREMENT: Visual Analogue Scale (VAS) ratings of aesthetic perception of the views. RESULTS: Anterior visible occlusion, photographed subject and view (p<0.001) had a significant effect on the aesthetic ratings. Also gender (p=0.001) and the interaction between gender and level of education (p=0.046) had a significant effect over the aesthetic rating. CONCLUSIONS: A lay panel perceived that the aesthetic impact of the visible anterior occlusion was greater in a dental view compared with a full facial view. The anterior visible occlusion, photographed subject, view type are factors, which influence the aesthetic perception of smiles. In addition, gender and level of education had an influence. (+info)
Dental aesthetics, self-awareness, and oral health-related quality of life in young adults.
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The aim of the present study was to explore the putative relationship between dental aesthetics and oral health-related quality of life (OHRQoL), taking into consideration the potential direct and moderating influence of private and public self-consciousness. The subjects of this cross-sectional survey were 148 university students. Dental aesthetics were assessed by means of the aesthetic component (AC) of the Index of Orthodontic Treatment Need (IOTN). OHRQoL was estimated using a modification of the scales 'social appearance concern' and 'appearance disapproval', and a novel dental self-confidence scale. In addition, the private and public self-consciousness scales were used. Two-factor analyses of variance were carried out with high and low levels of dental aesthetics and private and public self-consciousness as the independent variables and the OHRQoL scales as the dependent variables. It was found that dental aesthetics had a direct effect on all OHRQoL scale values. Private self-consciousness was related to social appearance concern, while public self-consciousness was associated with both social appearance concern and appearance disapproval. An interaction effect was identified which showed that the impact of dental aesthetics on social appearance concern was stronger in respondents with high private and public self-consciousness than in low scoring subjects. The findings of the study suggest that minor differences in dental aesthetics may have a significant effect on perceived OHRQoL. This effect was more significant in subjects with high self-consciousness. (+info)
Comparing a quality of life measure and the Aesthetic Component of the Index of Orthodontic Treatment Need (IOTN) in assessing orthodontic treatment need and concern.
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OBJECTIVE: To compare the use of the Aesthetic Component (AC) of IOTN and the Child Perceptions Questionnaire (CPQ) in assessing orthodontic treatment need and concern. DESIGN: Cross-sectional observational study. SUBJECTS AND METHODS: The subjects were 204 children aged 10-12 years studying in 10 schools in Bristol, UK. They completed a questionnaire comprising the CPQ and questions regarding orthodontic concern. AC scores as rated by the child and by the calibrated examiner were recorded. MAIN OUTCOME MEASURES: CPQ scores were calculated from the responses in the questionnaire. AC scores and responses to questions regarding orthodontic concern were recorded. RESULTS: The children gave themselves lower AC scores compared to the examiner (p<0.001). The only section of the CPQ that correlated significantly with Examiner AC was the emotional impacts section (rho=0.151). CPQ scores had a slightly higher correlation with self-perceived AC than Examiner AC. However, the correlations were still very low. The emotional impacts section of CPQ (rho=0.332) and overall CPQ score (rho=0.282) were better than the examiner AC (rho=0.209) at reflecting how bothered the children were by the alignment of their teeth, and how upset they would be if they couldn't receive orthodontic treatment (rho=0.464, 0.428 and 0.214, respectively). Children with a normative need for orthodontic treatment, based on examiner AC did not have a worse oral health-related quality of life. CONCLUSION(S): The CPQ and IOTN AC measure different attributes. There should be a shift towards using quality of life measures to supplement the IOTN in assessing the perceived need for orthodontic treatment. (+info)